Evan Facher’s mission over the past decade has been to grow the University of Pittsburgh’s Office of Innovation and Entrepreneurship (OIE), to maximize the societal benefit of the groundbreaking ideas and discoveries emanating from the labs and classrooms of Pitt faculty and students, and from regional businesses.
He never contemplated being on the receiving end of the innovation ecosystem he has been helping to build. But in the summer of 2024, he suffered a devastating eye injury that required a level of expertise that he would not have had access to in Pittsburgh if not for the significant investments made by Pitt and UPMC in world-class research and clinical care, in particular the capabilities at the UPMC Vision Institute at Mercy Pavilion in the city’s Uptown neighborhood.
Today, he is recovering from a first-of-its-kind surgery in Pittsburgh that is restoring a measure of normalcy to his life, allowing him to maintain his focus on driving Pitt innovation to new heights.
Growing Pitt’s Innovation Ecosystem
As Pitt’s annual sponsored research expenditures have soared past $1 billion, it has built upon historic strengths in areas including neuroscience, immunotherapy, women’s health, regenerative medicine, energy, space, and more. These advances are turbocharged by the university’s investments in advanced manufacturing, next-generation computing capabilities, and new partnerships to harness AI to accelerate translational science.
This growth in funding, combined with a sharpened focus on innovation commercialization, resulted in a record 444 inventions being disclosed by Pitt innovators to the Office of Innovation and Entrepreneurship in the last fiscal year.
As Vice Chancellor for Innovation and Entrepreneurship, Facher has collaborated with Pitt’s research and health sciences leadership to expand programs and funding opportunities that translate these discoveries from the lab to the marketplace.
He also assumed the role of Associate Dean for Commercial Translation at the School of Medicine, where he is coalescing the rapid growth of talent and innovation at Pitt and its clinical partner, UPMC, and where, unexpectedly, his own life would be impacted by a strategic bet on a world-renowned vision researcher.
A Random Accident
When Facher isn’t meeting with faculty around an innovation initiative, attending a student pitch competition, or hosting an industry partner, he enjoys supporting Pitt athletics, from women’s volleyball and softball to men’s basketball and everything in between.
On the last day of June 2024, he was engaged in his own recreational athletics at home when he suffered a blow to his left eye.
“I still don’t know how it happened,” he said. “All of a sudden, I’m lying on the ground, bleeding.”
Unaware of the severity of his injury, Facher and his wife proceeded to the nearest emergency room at UPMC Passavant Hospital in the North Hills, where the nurses removed the blood-soaked towel he was holding over his wound, cleaned his face, and gave him an ice pack and dressing to control the bleeding and swelling.
With a crowded waiting room, the time passed slowly.
After three-plus hours, he was guided to an exam room around 9 p.m., where the wait continued. The doctor ordered a CT scan that eventually showed no orbital bone fracture but did reveal something much worse — the eye globe itself had suffered a significant rupture.
With little more he could do at Passavant, the doctor put seven stitches in Facher’s left eyebrow and ordered an ambulance to shuttle him to the UPMC Vision Institute.
“I kept trying to look out my left eye, and I could see some faint light, but it was yellow. There was nothing else. It was as if my eye lens had been painted over. I was increasingly worried – especially when the CT scan came back, and I didn’t know what it meant for my long-term vision,” he said.
As his concern grew, Facher pulled out his phone while in the ER bed around 11 p.m. and emailed José-Alain Sahel, Chair of the Pitt Department of Ophthalmology and director of the Vision Institute, with whom he had collaborated on numerous intellectual property and licensing opportunities since Sahel’s arrival at Pitt in 2016.
Much to his surprise, Sahel replied within minutes, informing him who would be responsible for his care upon arrival at the Vision Institute and who he would be seeing the next day.
Then, for the first time in his life, Facher climbed into an ambulance. As he spoke with one of the paramedics, named Courtney, he learned that she had completed her bachelor’s degree in emergency medicine through Pitt’s School of Health and Rehabilitation Sciences (SHRS), with which the OIE partners for an annual innovation pitch competition, and has developed a deep pipeline of other innovation activities. SHRS is also the school where his oldest daughter graduated with her Master of Science degree in Athletic Training.
As the ambulance navigated down McKnight Road toward the city, Facher said he started to feel a bit more reassured and calmer as he put his trust in the capabilities of the health care innovation ecosystem he had helped nurture and would now nurture him.
A Vision Restoration Pioneer Chooses Pitt
From 2008 to 2020, José-Alain Sahel transformed Sorbonne University’s Institut de la Vision in Paris into one of the world’s top ophthalmologic research centers by uniting cross-disciplinary scientists and surgeons to advance vision restoration research and clinical care.
However, he was ready for a new opportunity when Pitt recruited him in 2016 to recreate it on an even grander scale in Pittsburgh, building on an impressive multidisciplinary core already in place. He accepted, and for a time he straddled the Atlantic Ocean, holding appointments in both institutions.
Facher was among the initial cadre of people that he was advised to meet as soon as possible upon arriving at Pitt.
“Before coming to Pitt, I had created multiple companies and partnerships with industry. After arriving at Pitt, the FDA medical devices division wanted to establish a partnership based on a platform I had built in Paris,” he said, adding that Facher and the OIE were instrumental in crafting an agreement that has evolved into a new entity to expedite the approval of new vision restoration devices nationally.
“He (Facher) is a problem solver,” Sahel said. “Anytime I call him when we have a project that requires his office to intervene, he does, in a good way. He finds a way to make things work.”
When he received Facher’s message late that June evening, Sahel, a self-professed night owl who enjoys letting his mind wind down with light reading and classical music, quickly contacted the resident and attending physician on call at the Vision Institute to discuss Facher’s case.
“The (CT) imaging was pretty bad,” Sahel said. “In some instances, like this, the eye is lost.”
He then contacted Andrew Eller, the director of ocular trauma, to discuss the best choice for the surgeon to evaluate Facher the next morning. Eller and Sahel agreed that Michael Chang would initiate the surgery on the eye globe and that Boris Rosin should be on standby to evaluate the retinal damage.
Rosin jokes that his nickname among his surgical colleagues is “The Catfish” because he ends up with the cases that filter down to the bottom that nobody else wants.
His path to ophthalmology “is a bit convoluted,” he said. After an initial foray into math and software engineering left him unfulfilled, he turned to medicine, more specifically, studying deep brain stimulation to treat Parkinson’s Disease.
That morphed into a fascination with the eyes, a direct extension of the central nervous system connected to the brain by a 5-centimeter-long optic nerve, and, like the brain, possessing its own blood barrier. He completed an ophthalmology residency and fellowship in Israel to perfect his surgical technique. He then met Sahel in Hawaii at the ARVO conference – an annual global gathering of eye specialists where the latest trends in research and clinical care are shared.
“We sat on a bench and talked for about half an hour. We shook hands, and that was the most consequential handshake of my life,” he said. “I was interested in inherited retinal disease, and (Sahel) is a giant in the field. I was convinced (to come to Pittsburgh) before I heard his first words.”
Rosin said few places combine clinical practice and research in such a tight feedback loop as Pitt and the Vision Institute.
“The questions we have in the clinic get translated directly into research projects. Let’s say you have a retinal prosthetic. How do you implant that into a human being? That’s the question the researchers ask the clinicians,” he said. “It’s a self-sustaining environment of questions and answers going back and forth. We have 40 research faculty and twice the clinical faculty, and there are not many places in the world like that.”
Nine years into his Pitt tenure, despite the opening of the spacious and visually stunning Vision Institute facility, the tremendous growth in the number of faculty and clinicians, and the outpouring of discoveries making their way from the lab to the patient through commercial translation, Sahel retains his trademark humility.
“We have made a lot of progress towards providing the highest quality of care,” he said, before allowing that even his wife, who he said typically has a healthy, balanced perspective on his accomplishments, is impressed with the new facility.
Opened in 2023 across from Mercy Hospital, the Vision Institute boasts 410,000 square feet of clinical and research space, with eight state-of-the-art operating rooms. It includes a dedicated clinical trials center and a range of patient-centered resources, including a life skills apartment and a rooftop sensory garden.
While proud of the structure, Sahel is more focused on the people and the blending of diverse talent in service to patients.
“It’s like chamber music,” he said. “Every individual patient raises major questions that require us to formulate these into focused areas of research and bring them into the lab. It may involve two, three, or four experts from different areas who know how to play well together to get the right answer. And clinical management of complex cases, especially traumas, benefits tremendously from the synergistic expertise of several surgeons
And so it was for Facher that a group of experts assembled to collaborate on his care.
Buckle Up
After arriving at the Mercy Hospital ER past midnight, Facher was briefly examined by the attending physician and the Vision Institute resident on call. He then had a team of clinicians and nurses checking on his vitals and his vision while he tried to catch brief snatches of sleep over the next several hours.
When he awoke in the morning, Evan Waxman, Division Chief of Comprehensive Eye Services, arrived to assure him he was in good hands, but added that until they explored inside his eye, they couldn’t know the full extent of the damage and what procedures would be necessary. Waxman laid out what the next few hours would look like until they would take him in for surgery.
Around noon, Facher transferred from the Mercy Hospital ER to the Vision Institute across the street for surgery. As Evan prepared for surgery, Dr. Eller swung by, assuring him the best and brightest had crafted a plan for the procedures ahead.
Even with only one functioning eye, Facher’s first impression left him awestruck.
“Previously, I had been in the public spaces of the Vision Institute within UPMC Mercy Pavilion, and knew it was a beautiful building, meticulously laid out by Dr. Sahel with intentional patient-centered functionality. But lying on my back, being wheeled around, I could take in the rest of the facility,” he said. “The hallways have big windows for the staff and patients to enjoy the outside world, and the operating room was brand new and much larger than I anticipated it would be,” he said.
But he didn’t have long to observe after he was greeted by Dr. Chang and the anesthesiologist, who asked him to start counting backward from 10.
Rosin was in an adjacent operating room when he said his phone kept buzzing. A nurse answered, “Dr. Eller is on the line, requesting that you report to Operating Room Two as soon as possible to assist in a trauma case,’” Rosin recalled.
“The next person to call was Dr. Sahel, who also said I should go to Operating Room Two,” Rosin said, laughing.
When he finished with his patient, he joined Chang, who was closing the rupture in the eye. Rosin quickly concluded that the significant extent of the ocular damage, which obviously involved the retina, required a big decision.
Dr. Rosin’s concern was for the development of a retinal detachment, which is usually addressed through a procedure called a vitrectomy. In a vitrectomy, the vitreous gel inside of the eye is removed using tiny instruments. Then, the retina is reattached by flattening it with the injection of an air bubble, as if inflating a balloon. This is followed by the application of laser light treatment around the retinal tear. Later, at the conclusion of the surgery, the air bubble that holds the retina in place is replaced with a gas that dissolves more slowly than air. The laser scars create an adhesion of the retina to the wall of the eye. The gas absorbs after a few weeks, at which point the laser scars are “matured” and the retina is sealed.
Rosin did not feel that a vitrectomy alone was sufficient to ultimately repair his eye. An additional procedure was necessary: a scleral buckle.
In this procedure, the surgeon sews a silicone band, called a scleral buckle, onto the wall of the eye which is buried under the eye’s soft tissues. The buckle indents the eye wall inward to reduce the traction on the retina and help hold the retina in place.
With Facher under anesthesia, Rosin met Facher’s wife and family in the waiting room. He explained the plan based on what was found during his initial evaluation to obtain her consent to advance with the buckle procedure.
In total, after five hours in the operating room, the rupture was repaired and the retina was successfully reattached in this first surgery on Facher’s journey toward vision restoration.
Waking up to a New Normal
“When I initially woke up, I was alone, and my left eye was bandaged. I didn’t know how long the procedure was or the prognosis,” Facher said, adding that his wife came in not long after to let him know the surgery was a success to close the globe and repair the retina. But she also broke the news that his lens was completely shattered and roughly 30 percent of his iris was destroyed in the accident.
The next morning, when the nurse removed the bandages, he could see light, and it was no longer yellow, but there was still no vision. The damaged iris also made his eye sensitive to light. The iris functions to open and close the pupil, allowing more or less light in the eye as needed. Without a functioning iris, Facher’s pupil was locked in a predominantly open position.
Facher soon met Rosin for the first time and received a detailed explanation of the damage and the repairs that had been made. Rosin then mapped out the next steps and provided a sense of the longer path forward.
“Dr. Rosin was transparent about the extent of the damage but also portrayed confidence that given the talent and capabilities at the Vision Institute, there was a good possibility of restoring vision in my eye despite how dire it seemed at the time,” Facher said. “I remember him saying, ‘Sometimes it is better to be lucky than good.’ I knew I was lucky to have a great, and not just a good, care team to support whatever the road forward was going to be.”
After discharge, he had to sleep completely flat on his back without a pillow for six weeks as the retina healed, causing severe bouts of vertigo and general challenges with being able to rest for longer periods of time to help the healing process.
In addition to severe light sensitivity, which required him to wear dark sunglasses, even in the supermarket, Facher struggled with depth perception and regularly bumped into people or objects on his left side.
But he was soon able to return to work as his doctors laid out a treatment plan that would likely include two additional surgeries.
The second occurred about a month after the first. Rosin removed the damaged lens, cleaned out the remaining impurities in the eye fluid, and performed another small laser correction to the retina in a two-and-a-half-hour procedure.
“Once the bandages were removed the day after the second surgery, the first thing I noticed was when they went to check pressure in the eye, I could tell the difference between a green circle and a red one on the device,” he said. “It was still not a clear view, but when I looked through a filter with pin holes to examine the eye chart, I could see the outline of a letter on the screen across the room. It was a tiny step, but I felt like there was hope for some future vision recovery.”
At a follow-up visit, Rosin called in his colleague Vishal Jhanji for a real-time consultation on how to deal with the damaged lens and iris.
“This is an example of the power of the vision ecosystem Pitt is building,” Facher said. “While I am sitting in the exam chair with Dr. Rosin, a renowned retinal surgeon, he casually brought in Dr. Jhanji, a world-renowned cornea expert, to discuss the options for moving forward. There are only a few places in the world where this kind of ‘eye’ power exists and can be dialed up on demand by pulling someone out of the hallway and into an exam room,” he said.
Rosin and Jhanji brought Sahel and Ian Conner, a leading glaucoma and anterior segment specialist, into the consultation. Conner suggested inserting an artificial silicone iris simultaneously with an artificial intraocular lens.
While the artificial lens technology has been the gold standard since the 1980s, the artificial iris has only been approved by the FDA within the past few years and had not been implanted in a person in Pittsburgh.
The only company to date approved to market the device is based in Germany, crafting each implant by hand to enable the reconstruction of the lost tissue and reduce extreme light sensitivity. In Facher’s case, there was no workable Plan B, making the artificial iris the only clear path forward.
The surgeons wanted to wait about six months (December 2024) for the third, and believed to be final, surgery, which would include the implantation of the artificial lens and the artificial iris, as well as some additional minor repairs to the retina and the removal of the sutures from the initial repair of the eye globe.
Hurry Up and Wait
There was only one remaining hurdle – Facher’s employer-provided insurance would not fully cover the procedure. The artificial iris is FDA cleared and Medicare considers it a covered service for medical necessity, including for traumatic iris loss due to an accident or injury like Facher’s. However, commercial insurer decisions for new devices and procedures are based not only on Medicare guidance, but also on additional, industry-standard, peer-reviewed clinical evidence. For now, many private insurers continue to classify the device as experimental.
This conundrum left Facher frustrated, and the next surgery in limbo for nearly a year and a half as he went back and forth with his insurance company. Ultimately, the implant itself was not covered; however, his operating room costs were. The result was Facher would have to pay out of pocket for the device – a cost of roughly $10,000. This caught Facher off guard, especially given the lack of alternatives.
“I assumed that since the FDA cleared the device years ago, and other insurers cover it, it would be approved here as well,” he explained.
Driven by a desire to regain his sight and advocate for others in his situation to have accessibility to the device, Facher chose to pay for the device out of pocket.
The Vision Institute team was thrilled to be able to offer Facher this treatment on the cutting edge of innovative medicine–a first for UPMC and for the region–in December 2025.
Conner estimates that about a half dozen of his patients would be good candidates for artificial iris implants annually.
“It’s an important procedure to offer,” he said.
With his own role in driving Pitt innovation forward in mind, Facher added, “The Vision Institute is paving the way for the future of medicine; these are the kinds of cutting-edge procedures that must be available.”
Long-Awaited Day Arrives
The human iris can contain a range of color combinations based on the amount of melanin in the eye and the light scattering effect of the eye. To get an accurate match, high-definition photos of Facher’s eye were sent to the company in Germany. Facher and his wife sat down with Conner to sign and date the photos to begin the manufacturing process, which took several months.
Conner then had to complete an online module for performing the surgery, after which the company sent him a model eye to practice the rare procedure, having never done one before.
Finally, Facher received what he had been looking forward to for over a year: a surgery date of December 15, 2025 – 18 months after the initial injury and a year after the procedure was initially targeted to happen.
During the surgery, Conner sutured the device along with the new lens into the wall of the eye, as Evan’s injury had destroyed both the capsular bag as well as the zonular ligament that are typically used to secure an intraocular lens.
This three-and-a-half-hour procedure went as planned. However, when the surgeons also attempted to clear out scar tissue on the retina from the previous surgeries, a new small tear was identified that required a procedure for retinal repair using a laser with the insertion of a gas bubble for maintaining pressure.
For a week after the surgery, Facher had to keep his head down for 50 minutes of every hour as the bubble dissipated. And for the first two months of his recovery, his eye was red and irritated from the inflammation and the microsutures on the eye surface that gradually dissolved.
But he was pleased to notice a significant improvement in vision in that eye, as well as a reduction in the light sensitivity.
“The recovery has been a little slower than anticipated, but everything is moving in a positive direction,” he said. “I think everyone was hoping for the movie script ending of the bandage being removed and things being exactly like they were before the accident. It is not that yet, but I can see again, whereas just a few weeks back, there was just a blurry white light.”
Facher received a recommendation for an optometrist from Rosin, who fitted him with a new eyeglass prescription to help further restore vision and even slightly improved it in his right eye as a bonus.
Shifting Focus Back to Innovation
Last June, Facher visited the Vision Institute, but this time it wasn’t for surgery or an exam; it was in his role driving Pitt’s innovation ecosystem forward. He presided over the ceremonial signing of the license for Pitt’s 15th startup company launched from the university in fiscal 2025.
The company, Netramind, comes from the lab of Jay Chhablani, who, like Rosin and so many others, was lured from his native country for the opportunity to work alongside Sahel. Chhablani, vice chair of clinical trials and director of clinical research at the Vision Institute, has harnessed AI to create a platform that analyzes ophthalmic data to more quickly and accurately predict the progression of eye diseases, such as macular degeneration, empowering clinicians to develop better treatment plans.
It is one of many innovations from the Vision Institute that pursues the simple mission Sahel outlined to “help people to retain and regain the joy of seeing.”
“There is no doubt that this discovery, like the many others being made at the Vision Institute, will significantly impact people’s sight,” Facher said. “And these innovations would not have been developed at Pitt without Dr. Sahel’s presence, as it is one of the main things attracting commercially-leaning talent here, driving the local discovery ecosystem in the field of ophthalmology.”
Pitt researchers under Sahel’s leadership are taking a multi-pronged approach – focusing on innovation at the intersection of clinical care.
Sahel’s own research, recently published in the New England Journal of Medicine, demonstrates that a retinal implant that he has co-developed with scientists at Stanford University and the University of Bonn in Germany helped people suffering macular degeneration achieve an average improvement of five lines on a standard eye chart.
Another angle Pitt researchers are taking for people with inherited retinal disorders is delivering genes directly to the eye using viral vectors. Avista Therapeutics, a Pitt startup following this approach, partnered with pharmaceutical giant Roche AG to bring these therapies to market in a deal that could be worth $1 billion if milestones are met.
Sahel and Leah Byrne, co-founders of Avista, have developed another technology that recently received funding through Pitt.INC, a commercialization acceleration program for innovations from the School of Medicine, in partnership with the OIE.
“We have several (technologies) in the pipeline for commercialization and a many more on the way,” Sahel said.
Sahel is also excited about the approaching opening of the Pitt BioForge next year. He has visited ElevateBio, the Boston-based operator of advanced biomanufacturing facilities, which will be opening its newest BaseCamp manufacturing facility within BioForge, providing gene editing, pluripotent stem cell, and cell, vector, and protein engineering capabilities.
“Having this level of expertise and engagement in our own backyard is going to be a game-changer for us,” Sahel said, pointing to the Vision Institute’s efforts around gene therapy and gene editing.
The ability to reduce research to practice through translation is a core way universities impact the world. These concepts are woven into the fabric of the University of Pittsburgh, embodied in both the University’s mission statement and the Plan for Pitt, which emphasizes the importance of creativity, innovation, and translation on campus. The Vision Institute embraces this approach, starting from the top down. This is precisely why the best and brightest vision researchers and clinicians from around the globe have come to Pittsburgh, providing the capability for broad ophthalmologic care that exists few places in the world.
“Before my accident, I was fortunate to play a small role in helping Dr. Sahel build this world-leading translation ecosystem. Now that this very organization has helped to restore the majority of my sight, I find myself in a unique position of going beyond the theoretical models that justify this investment for our region,” Facher said. “I am a living testament to its impact. It is a profound demonstration that when technology-based economic development addresses its purpose, it dramatically changes a person’s world for the better. The benefit to society isn’t just found on a balance sheet; it’s found in every life we change.”
