Bio

Bio


Andrea Lora Kossler, MD, is Assistant Professor of Ophthalmology at Stanford University School of Medicine and Co-Director of the Ophthalmic Plastic, Reconstructive Surgery and Orbital Oncology Service at the Byers Eye Institute at Stanford. She specializes in plastic and reconstructive surgery of the forehead, mid-face, and eyes with a special interest in aesthetic medicine. Dr. Kossler’s research interests include thyroid eye disease, orbital oncology, and neurostimulation of the lacrimal gland to treat dry eye disease.

Andrea earned her medical degree from Georgetown University School of Medicine where she graduated summa cum laude and valedictorian of her class. She holds a Bachelor of Science degree from the University of Florida where she graduated with highest honors. She completed her internship in internal medicine at the Mount Sinai Medical Center and her residency in Ophthalmology at the number one ranked Bascom Palmer Eye Institute at the University of Miami Miller School of Medicine. She continued at the Bascom Palmer Eye Institute to finish her fellowship in Ophthalmic Plastic and Reconstructive surgery and served as a Clinic Instructor of Ophthalmology for two years.

Clinical Focus


  • Pediatric Oculoplastics
  • Thyroid Eye Disease
  • Ophthalmic Reconstructive & Facial Plastic Surgery
  • Mohs Reconstruction & Eyelid Surgery
  • Cosmetic Surgery & Treatments
  • Ophthalmology
  • Orbital Oncology

Academic Appointments


Administrative Appointments


  • Co-Director, Ophthalmic Plastic & Reconstructive Surgery (2012 - Present)
  • Director, Oculoplastic Cosmetic Surgery & Treatments (2013 - Present)

Honors & Awards


  • Marvin Quickert Thesis Award, American Society of Ophthalmic Plastic & Reconstructive Surgery (ASOPRS) (2013)
  • Best Ocular & Orbital Oncology Paper AAO Annual Conference, American Academy of Ophthalmology (AAO) (2012)
  • Valedictorian, summa cum laude, Georgetown School of Medicine (2006)
  • Frank G. Standaert Award, Department of Pharmacology, Georgetown University (2006)
  • Kober Award, Georgetown School of Medicine (2006)
  • Milton Corn, MD Award, Georgeown School of Medicine (2005)

Professional Education


  • Medical Education:Georgetown University (2006) DC
  • Board Certification, American Board of Ophthalmology, Ophthalmology (2012)
  • Fellowship, Bascom Palmer Eye Institute, University of Miami, Ophthalmic Plastic, Reconstructive Surgery & Orbital Oncology (2012)
  • Fellowship:Bascom Palmer Eye Institute (2012) FL
  • Residency:Bascom Palmer Eye Institute (2010) FL
  • Internship:Mount Sinai Med Ctr/ Miami Bch (2007) FL

Research & Scholarship

Current Research and Scholarly Interests


Thyroid Eye Disease
Adenoid Cystic Carcinoma of the Lacrimal Gland
Lacrimal Gland Stimulation for the Treatment of Dry Eyes
Neurostimulation
Orbital Tumors
Floppy Eyelid Syndrome and Obstructive Sleep Apnea

Clinical Trials


  • The Secondary Beneficial Effects of Prostaglandin Analog Treatment in Thyroid Eye Disease Patients. Not Recruiting

    The purpose of this study is to evaluate the potential secondary beneficial effect of prostaglandin analogues (PA) treatment in thyroid eye disease (TED) patients. This study aims to determine if PA would change the course of the orbitopathy in TED patients by altering the progression of the common features of TED, including fatty hypertrophy, proptosis, eyelid retraction and optic nerve compression. The eyes with thyroid eye disease and elevated intraocular pressure will be randomised to the PA treatment and the other eye will serve as a control eye and will be treated with Timolol.

    Stanford is currently not accepting patients for this trial. For more information, please contact Barbara Bartlett, 650-724-9259.

    View full details

Teaching

2013-14 Courses


Postdoctoral Advisees


Publications

Journal Articles


  • Author reply. Ophthalmology Tse, D. T., Kossler, A. L., Feuer, W. J., Benedetto, P. W. 2014; 121 (1): e8-e10

    View details for DOI 10.1016/j.ophtha.2013.11.012

    View details for PubMedID 24268860

  • Long-Term Outcomes of Neoadjuvant Intra-arterial Cytoreductive Chemotherapy for Lacrimal Gland Adenoid Cystic Carcinoma. Ophthalmology Tse, D. T., Kossler, A. L., Feuer, W. J., Benedetto, P. W. 2013

    Abstract

    PURPOSE: To compare the long-term outcomes after intra-arterial cytoreductive chemotherapy (IACC) with conventional treatment for lacrimal gland adenoid cystic carcinoma (ACC). DESIGN: Retrospective case series. PARTICIPANTS: Nineteen consecutive patients treated with IACC, followed by orbital exenteration, chemoradiotherapy, and intravenous chemotherapy. INTERVENTIONS: Analyses of the histologic characteristics of biopsy specimens, extent of disease at the time of diagnosis, diagnostic surgical procedures, incidence of locoregional recurrences or distant metastases, disease-free survival time, response to IACC, tumor margins at definitive surgery, and toxicity and complications. MAIN OUTCOME MEASURES: Disease relapse, disease-free survival, and chemotherapeutic complications. RESULTS: Eight patients with an intact lacrimal artery had significantly better outcomes for survival (100% vs. 28.6% at 10 years), cause-specific mortality, and recurrences (all P = 0.002, log-rank test) than conventionally treated patients from the University of Miami Miller School of Medicine. These 8 patients (group 1) had cumulative 10-year disease-free survival of 100% compared with 50% for 11 patients (group 2) who had an absence of the lacrimal artery or deviated from the treatment protocol (P = 0.035) and 14.3% for conventionally treated patients (P<0.001). Likewise, group 2 was associated with lower cause-specific mortality than the institutional comparator group (P = 0.038). Prior tumor resection with lateral wall osteotomy, delay in IACC implementation or exenteration, and failure to adhere to protocol are risk factors for suboptimal outcomes. CONCLUSIONS: Neoadjuvant IACC seems to improve overall survival and decrease disease recurrence. An intact lacrimal artery, no disruption of bone barrier or tumor manipulation other than incisional biopsy, and protocol compliance are factors responsible for favorable outcomes. The chemotoxicity complication rate is limited and manageable. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

    View details for PubMedID 23582989

  • Time Domain versus Spectral Domain Optical Coherence Tomography (OCT) in the Diagnosis and Treatment of Angioid Streaks Ophthalmology Web Lora-Kossler, A. 2008
  • Conjunctival Squamous Cell Carcinoma with Intraocular and Intraorbital Invasion Ophthalmology Times Lora-Kossler, A., Johnson, T. 2008
  • Systemic Multiple Myeloma with Secondary Orbital Plasmacytoma Ophthalmology Times Andrea, L. 2008
  • Global Rating Assessment of Skills in Intraocular Surgery (GRASIS) OPHTHALMOLOGY Cremers, S. L., Lora, A. N., Ferrufino-Ponce, Z. K. 2005; 112 (10): 1655-1660

    Abstract

    The American Board of Ophthalmology in conjunction with the Accreditation Council for Graduate Medical Education has mandated the systematic assessment of surgical competence of ophthalmology residents at all residency programs. We present a tool complementary to the Objective Assessment of Skills in Intraocular Surgery (OASIS) to assess residents' surgical competence.Twenty experts in resident education, including the chiefs of all ophthalmology services and the chief resident at the Harvard Medical School Department of Ophthalmology.A 1-page subjective evaluation form was developed in conjunction with the Objective Assessment of Skills in Intraocular Surgery evaluation form to assess the surgical skills of residents. A panel of surgeons at the Harvard Medical School Department of Ophthalmology at the Massachusetts Eye and Ear Infirmary reviewed the form and provided constructive feedback.Experts' comments were incorporated, establishing face and content validity.The Global Rating Assessment of Skills in Intraocular Surgery (GRASIS) has face and content validity. It can be used to assess a resident's surgical care of patients as well as a resident's surgical knowledge, preparedness, and interpersonal skills. Reliability and predictive validity will be determined at our institution. We believe the GRASIS evaluation form will be a valuable tool in conjunction with the OASIS evaluation form for assessing ophthalmology residents' surgical skills at other residency programs as well.

    View details for DOI 10.1016/j.ophtha.2005.05.010

    View details for Web of Science ID 000232299200003

    View details for PubMedID 16102834

  • Impact of Depressive Illness on Emergency Department Recidivism: A New Approach to the “Frequent Flyer” Annals of Emergency Medicine Lora-Kossler, A., Simpsom, M., Freed, M., Milzman, D. 2004; 23 (44.4)
  • Effects of monocular viewing and eye dominance on spatial attention BRAIN Roth, H. L., Lora, A. N., Heilman, K. M. 2002; 125: 2023-2035

    Abstract

    Observations in primates and patients with unilateral spatial neglect have suggested that patching of the eye ipsilateral to the injury and contralateral to the neglected space can sometimes improve attention to the neglected space. Investigators have generally attributed the effects of monocular eye patching to activation of subcortical centers that interact with cortical attentional systems. Eye patching is thought to produce preferential activation of attentional systems contralateral to the viewing eye. In this study we examined the effect of monocular eye patching on attentional biases in normal subjects. When normal subjects bisect vertical (radial) lines using both eyes, they demonstrate a far attentional bias, misbisecting lines away from their body. In a monocular viewing experiment, we found that the majority of subjects, who were right eye dominant, had relatively nearer bisections and a diminished far bias when they used their right eye (left eye covered) compared with when they used their left eye (right eye covered). The smaller group of subjects who were left eye dominant had relatively nearer bisections and a diminished far bias when they used their left eye compared with when they used their right eye. In the hemispatial placement experiment, we directly manipulated hemispheric engagement by having subjects perform the same task in right and left hemispace. We found that right eye dominant subjects had a diminished far bias in right hemispace relative to left hemispace. Left eye dominant subjects showed the opposite pattern and had a diminished far bias in left hemispace. For both groups, spatial presentation affected performance more for the non-dominant eye. The results suggest that monocular viewing is associated with preferential activation of attentional systems in the contralateral hemisphere, and that the right hemisphere (at least in right eye dominant subjects) is biased towards far space. Finally, the results suggest that the poorly understood phenomenon of eye dominance may be related to hemispheric specialization for visual attention.

    View details for Web of Science ID 000177504900010

    View details for PubMedID 12183348

Books and Book Chapters


  • Hordeolum, Chalazion and Blepharitis Primary Care: A Collaborative Practice Kossler, A., Banta, J. edited by Buttaro, T. M., Trybulski, J., Bailey, P. P., Sandberg-Cook, J. Mosby. 2012; 4th
  • Dacryocystitis and Nasolacrimal Duct Obstruction Primary Care: A Collaborative Practice Kossler, K. L., Banta, J. edited by Buttaro, T. M., Bailey, P. P., Trybulski, J., Sandberg-Cook, J. Mosby. 2012
  • Pediatric Cataract Ophthalmic Surgical Procedures Cremers, S., Lora-Kossler, A., Azar, N. edited by Hersh, P. S., Zagelbaum, B., Cremers, S. Thieme. 2009; 2nd

Presentations


  • Neurostimulation of the Lacrimal Nerve for Enhanced Tear Production.

    Neurostimulation of the Lacrimal Nerve for Enhanced Tear Production. Marvin Quickert Award Thesis Oral Presentation, Fall Scientific Symposium. November 2013

    Presented To

    American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS)

    Location

    New Orleans, LA

  • Long-Term Outcomes of Neoadjuvant Intraarterial Cytoreductive Chemotherapy for Lacrimal Gland Adenoid Cystic Carcinoma

    Long-Term Outcomes of Neoadjuvant Intraarterial Cytoreductive Chemotherapy for Lacrimal Gland Adenoid Cystic Carcinoma. Annual Meeting. November 2012,

    Presented To

    American Academy of Ophthalmology (AAO)

    Location

    Chicago, IL

  • Surgical Management of Optic Nerve Sheath Amyloidosis with Subsequent Orbital Infiltration

    Surgical Management of Optic Nerve Sheath Amyloidosis with Subsequent Orbital Infiltration. Fall Scientific Symposium. October 2011

    Presented To

    American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS)

    Location

    Orlando, FL

  • Echographic and Pathologic Correlation: A 10 year Study or Orbital Echography.

    Presented To

    Bascom Palmer Eye Institute

    Location

    Miami, FL

  • Pre-surgical High Frequency Ultrasound in the Diagnosis and Surgical Management of Periocular Basal Cell Carcinoma.

    Time Period

    June 1, 2010

    Presented To

    Bascom Palmer Eye Institute, University of Miami

    Location

    Miami, FL

  • Ophthalmic artery occlusion after embolization for an orbital arteriovenous malformation.

    Time Period

    10/2011

    Presented To

    American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS)

    Location

    Orlando, FL

  • Risk Assessment in Cataract Surgery (RACS)

    Time Period

    10/2005

    Presented To

    American Academy of Ophthalmology (AAO)

    Location

    Chicago, IL

  • Tips and Tricks in Eyelid, Lacrimal and Orbital Trauma. Oculoplastics, Lacrimal System and Orbit

    Lecture Session

    Time Period

    4/2014

    Presented To

    World Ophthalmology Congress

    Location

    Tokyo, Japan

  • New Orbital Techniques in Oculoplastics

    Guest Speaker at Bay Area Kaiser Conference

    Time Period

    11/2013

    Presented To

    Bay Area Kaiser Oculoplastics Conference

    Location

    Santa Clara, CA

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