About

Robert C. Kersten, MD, FACS, FASOPRS, is one of the country’s top oculoplastic surgeons practicing at the John A. Moran Eye Center at the University of Utah. He treats adults and children with congenital and acquired disorders of the soft tissues and bones around the eyes, and performs cosmetic eyelid and upper facial rejuvenation. Dr. Kersten has authored more than 200 publications on the diagnosis and treatment of disorders and cosmetic problems in the eye area. He has been recognized by his peers as one of America’s Best Doctors for over 20 years and has received numerous awards, including the American Academy of Ophthalmology’s Lifetime Achievement Award, the American Society of Ophthalmic Plastic and Reconstructive Surgery Foundation's 2025 Rick Anderson Award for Surgical Innovation, and the 2021 Dortzbach Award for his outstanding teaching, academic, scientific, and scholarly achievements. He serves as program director and selection chair for Moran's oculoplastic fellowship and has lectured internationally in more than 30 countries. Dr. Kersten earned his medical degree at the University of Iowa Carver College of Medicine, where he also completed his residency in ophthalmology and a fellowship in ophthalmic plastic, orbital, and reconstructive surgery. Throughout his career, he has devoted significant time to outreach care, performing surgeries and training ophthalmologists worldwide.

Research topics

• Medicine
• Internal medicine
• Surgery
• Intensive care medicine
• Dermatology
• Ophthalmology
• Algorithm

Selected publications

• Optimizing cost-effectiveness in the work-up of orbital inflammation: a multicenter, retrospective study

  Orbit · 2026-01-30

  article

  PURPOSE: To evaluate diagnostic tests and patient characteristics associated with specific diagnoses of orbital inflammation to optimize cost-effectiveness. METHODS: A retrospective, observational case series, including 121 adult patients who underwent work-up for a clinically inflamed orbit. Chart review collected demographic and clinical information. Cost of testing was estimated based on publicly available data. Logistic regression was used to identify factors associated with a specific diagnosis. RESULTS: < 0.05) with older age (OR 1.6 per decade), male gender (OR 2.9), bilateral disease (OR 4.8), diffuse inflammation (OR 11.6), and bone involvement (OR 20.9). CONCLUSIONS: Orbital inflammation was associated with a broad diagnostic work-up that led to a nonspecific diagnosis in the majority of cases. Cost savings may be achieved by judicious use of tests that provide limited diagnostic information (ANA, anti-dsDNA, ACE, anti-CCP, ESR, CRP, platelets) and reserving comprehensive work-up for patients with risk factors.

  PublisherDOI

• Glucagon-Like Peptide-1 Receptor Agonists and the Risk of Thyroid Eye Disease

  Ophthalmic Plastic and Reconstructive Surgery · 2026-04-08

  articleSenior author

  PURPOSE: To evaluate whether glucagon-like peptide-1 receptor agonists (GLP-1RA) are associated with an altered risk of thyroid eye disease (TED) compared with other non-GLP-1RA glucose-lowering medications in patients with thyroid disease. METHODS: This retrospective, population-based cohort study utilized the TriNetX U.S. Collaborative Network to identify patients with thyroid disease initiating a GLP-1RA or a non-GLP-1RA active control medication. After 1:1 propensity score matching, 2 balanced cohorts of 173,618 patients each were analyzed. Matching variables included demographics, comorbidities, hemoglobin A1c, body mass index, concomitant diabetes medications, radioactive iodine therapy, thyroid-specific laboratory values, and diabetes complication severity. Outcomes included TED-related diagnoses, surgical interventions, and systemic steroid use. Time-to-event analyses were performed using Cox proportional hazards models. RESULTS: GLP-1RA use was associated with a significantly lower risk of TED compared with the active control group. The risk of a composite TED-related diagnosis was lower at 1 year (hazard ratio [HR] 0.82; 95% confidence interval [CI], 0.76-0.88), 2 years (HR 0.86; 95% CI, 0.81-0.91), and 3 years (HR 0.90; 95% CI, 0.86-0.95). Marked reductions were observed for TED-related surgical interventions (1-year HR 0.42, 95% CI 0.36-0.49; 3-year HR 0.54, 95% CI 0.48-0.61) and systemic steroid use. Subgroup analyses of patients with hyperthyroidism and individual agents demonstrated consistent protective associations. CONCLUSIONS: In a large, rigorously matched cohort, GLP-1RA therapy was associated with a reduced risk of TED diagnoses, surgeries, and systemic steroid use compared to other glucose-lowering medications. These findings suggest a potential protective role for GLP-1 signaling in modulating orbital inflammation, though prospective trials are required for confirmation.

  PublisherDOI

• Re: “The Algorithmic Role of Critical Radiographic Features in the Treatment of Angioinvasive Fungal Sinusitis”

  Ophthalmic Plastic and Reconstructive Surgery · 2025-11-01 · 1 citations

  articleSenior author
  PublisherDOI

• Müller Muscle Conjunctival Resection: A Prospective Multicenter Comparison of Eyelid Height at the Immediate, 1-Week, and 3-Month Postoperative Time Points

  Ophthalmic Plastic and Reconstructive Surgery · 2024-08-28

  article

  PURPOSE: The primary objective was to document change in postoperative marginal reflex distance-1 (MRD1) after Müller muscle conjunctival resection surgery. The secondary objective was to identify predictors of change in postoperative MRD1. METHODS: A multicenter prospective cohort study was performed on patients consecutively recruited for Müller muscle conjunctival resection. MRD1 was measured immediately after Müller muscle conjunctival resection, at the 1-week postoperative visit, and the ≥3-month postoperative visit. MRD1 at the immediate and 1-week time points were compared with MRD1 ≥3 months using descriptive statistics. Predictors of change in MRD1 were analyzed using multivariate regression analysis. RESULTS: A total of 150 patients (226 eyelids) were included. Regarding the immediate to ≥3-month interval, 53.8% of eyelids remained clinically similar (rise or fall ≤0.5 mm), 19.8% rose ≥1 mm, and 26.4% fell ≥1 mm. Regarding the 1-week to ≥3-month interval, 76.5% remained clinically similar, 17.3% rose ≥1 mm, and 6.2% fell ≥1 mm. No variable predicted change in MRD1 over either interval with both clinical and statistical significance. CONCLUSIONS: Immediate postoperative MRD1 is likely to reflect the late result in only 54% of cases. However, 1-week postoperative MRD1 is similar to the late result in 77% of cases and is highly unlikely (6%) to fall by the final visit. No variable significantly impacts change in postoperative MRD1.

  PublisherDOI

• Central Retinal Artery Occlusion Following Intralesional Triamcinolone Injection for IgG4-related Orbital Disease

  Ophthalmic Plastic and Reconstructive Surgery · 2024-09-27 · 2 citations

  articleOpen accessSenior authorCorresponding

  The risk of blindness associated with periocular and facial injections is well documented. Previous cases describing vision loss following a recent periocular or facial injection have emphasized the importance of facial "danger zones." To date, the literature suggests that nearly half of all cases of central retinal artery occlusion in the setting of a recent periocular or facial injection involve an injection in or around the nose. Here, the authors report the second known case of central retinal artery occlusion following a triamcinolone injection to the lacrimal gland. A 30-year-old female with a diagnosis of IgG4-related disease underwent lacrimal gland debulking with an intralesional steroid injection. She noted OD vision loss immediately after surgery, with posterior segment examination demonstrating retinal whitening with a cherry-red spot and intra-arterial yellow-white plaques. This case serves as a reminder to clinicians regarding the risk of iatrogenic embolism following triamcinolone injections around the face with special attention drawn to the lacrimal gland.

  PublisherDOI

• Invasive Fungal Sinusitis in an Immunocompetent Patient After Sinus Surgery for Chronic Rhinosinusitis with Nasal Polyps and a Mycetoma

  The Laryngoscope · 2024-04-23 · 3 citations

  article

  Acute invasive fungal sinusitis (AIFS) classically presents as an aggressive fungal infection that can spread beyond its origin in the sinuses in immunocompromised patients. Although there have been reports of AIFS in immunocompetent, non-diabetic patients, it is extremely rare and the true mechanism behind it is unknown. A thirty-eight year old immunocompetent, non-diabetic woman underwent bilateral ESS for chronic rhinosinusitis with nasal polyps at a tertiary care center and post-operatively developed AIFS. Patient underwent uncomplicated ESS, was packed with foam containing triamcinolone and discharged on steroid rinses and a prednisone taper. Surgical pathology demonstrated left-sided colonization with non-invasive fungal elements consistent with a mycetoma. She presented on post-operative Day 11 with headache and left-sided retro-orbital pain. A culture of her left nasal cavity grew Rhizopus spp and MRI demonstrated evidence of invasive fungal infection of left sphenoid mucosa as well as inflammatory changes in the left orbit centered at the orbital apex. She was started on amphotericin and underwent a left-sided debridement with biopsies which demonstrated angioinvasive fungal disease. Her vision in her left eye worsened to 20/800 and she was treated with transcutaneous retrobulbar injection of amphotericin B. After stable interval imaging she was discharged on a long-term course of antifungals. Extensive immunologic work-up was unremarkable. We describe a case of an immunocompetent patient who developed AIFS after sinus surgery for CRS and a mycetoma likely as a result of local immune suppression and post-surgical trauma. Laryngoscope, 134:4213-4216, 2024.

  PublisherDOI

• Evaluating for unrecognized deficits in perimetry associated with functional upper eyelid malposition

  Advances in Ophthalmology Practice and Research · 2024-02-01

  articleOpen accessSenior author

  Objective: To investigate whether functional upper eyelid malposition is associated with unrecognized deficits in automated perimetry among glaucoma patients by examining patients undergoing eyelid surgery who had not been identified as requiring eyelid taping during glaucoma field testing. Methods: In this retrospective pre-post study, an automated database search followed by manual chart review was used to identify eligible patients from January 2012 to March 2020. Included patients had reliable visual field testing within two years before and after functional upper blepharoplasty or ptosis repair and no comorbid ocular diagnoses. As part of routine practice, glaucoma visual field technicians taped patients with pupil-obstructing eyelid malposition; taped examinations were excluded from analysis. Clinical and demographic characteristics, mean deviation, and pattern standard deviation were evaluated within a two year period before and after eyelid surgery. Results: ​= ​0.700). Five of 17 eyes excluded from analysis due to unreliable pre-operative visual fields demonstrated substantial improvement after surgery. Conclusions: Functional upper eyelid malposition does not appear to cause spurious visual field abnormalities among glaucoma patients with reliable visual fields who were determined not to require eyelid taping at the time of their visual fields. Unreliable visual fields could be a sign of eyelid interference in this population.

  PublisherDOI

• Eye and Orbit Injuries Caused by Electric Scooters and Hoverboards in the United States

  Clinical ophthalmology · 2024-03-01 · 3 citations

  articleOpen access

  Introduction: To evaluate eye and orbital injuries in non-powered scooter, electric-scooter (e-scooter), and hoverboard riders in the United States (US) between 2014 and 2019. Methods: The National Electronic Injury Surveillance System (NEISS) was queried for head and neck injuries by body part codes related to non-powered scooters and powered scooters/hoverboards from 2014 to 2019. The NEISS complex sampling design was used to obtain US population projections of injuries and hospital admissions. Keywords were queried in case narratives to analyze trends in location, type, and mechanism of eye and orbit injuries. Results: Since their introduction, a 586% (p=0.01) increase in e-scooter injuries and 866% (p< 0.001) increase in hoverboard injuries were observed with an increase in hospital admissions seen in young adults (18– 34) in urban areas (e-scooter: 5980% and hoverboard: 479%). Descriptive narratives of the trauma noted eye injuries in 242 unweighted NEISS cases with only 30 cases appropriately documented under body part code 77: eyeball. Eye injuries increased 96.9% during the study period (p=0.23). Specifically, the most common ophthalmic injuries reported included eyebrow (40.9%) and eyelid (11.3%) lacerations, periorbital contusions (18.7%), orbit fractures (6.6%), and corneal abrasions (5.1%). Conclusion: There was a significant increase in both head and neck injury cases and hospital admissions related to e-scooters. Eye and orbit injuries similarly increased but were underreported by body part code compared to injury narratives. Orbital fractures were reported more frequently in injuries from e-scooters than non-powered scooters. Plain Language Summary: From 2014 to 2019, there were significant increases in both head and neck injuries and hospital admissions related to e-scooters, with eye and orbital injuries similarly increased but underreported by body part code compared to the injury narratives. Keywords: scooter, e-scooter, electric scooter, hoverboard, eye trauma, orbital fracture, orbit

  PublisherOA PDFDOI

• A Unique Medial Rectus Entrapment Configuration

  Ophthalmic Plastic and Reconstructive Surgery · 2024-05-22 · 1 citations

  articleSenior authorCorresponding

  FIGA 19-year-old female presented to the University of Utah emergency room with significant double vision after trauma to the OD. She had been skiing on the afternoon of the presentation and reported that when she landed a jump, her knee was driven up, striking her OD. Her diplopia was particularly exacerbated in her right gaze. Visual acuity was 20/20 OU without afferent pupillary defect. Intraocular pressure was within normal limits. Abduction of the OD was graded as a −4 and adduction was limited to −2 during emergency room evaluation. There was no previous significant ocular history or family history. MRI (Fig.), ordered by the emergency room staff, demonstrated a right inferior medial orbital wall lamina papyracea injury with herniation of the intraorbital contents through the small defect resulting in displacement and entrapment of the inferior half of the medial rectus muscle. This resulted in a J-shaped distortion of the muscle configuration. The patient was taken urgently to the operating room for repair. Intraoperatively, the medial rectus and intraorbital contents were noted to be caught within the medial wall inferiorly and were released. Immediately postoperatively the patient was noted to have regained full motility. This case demonstrates a medial wall fracture with entrapment of the inferior half of the medial rectus muscle in a configuration that the authors have not seen previously either clinically or reported in the literature. Of note, in this case, the abduction motility deficit was greater than adduction; however, the senior author has experienced an adduction deficit greater than the abduction deficit accompanying medial rectus entrapment in the past.

  PublisherDOI

• Transcutaneous Retrobulbar Amphotericin B Injection for Invasive Fungal Sinusitis with Orbital Involvement: A Systematic Review

  American Journal of Rhinology and Allergy · 2024-05-21 · 6 citations

  review

  BACKGROUND: Orbital involvement of invasive fungal sinusitis (IFS) is an ominous prognostic marker that should prompt rapid intervention. Transcutaneous retrobulbar administration of amphotericin B (TRAMB) is an off-label adjunctive treatment that can increase drug penetrance into diseased orbital tissue. To date, there is a lack of consensus regarding the use of TRAMB for treatment of IFS with orbital involvement. OBJECTIVE: This systematic review aims to synthesize the indications, efficacy, and potential complications of TRAMB. METHODS: PubMed, EMBASE, and Web of Science databases were probed for systematic review. Article search was conducted through June 2023 using the keywords "invasive fungal sinusitis," "invasive fungal rhinosinusitis," "rhino-orbital mucormycosis," "rhinosinusitis," "orbital," "retrobulbar," and "amphotericin." RESULTS: In suitable cases as determined by radiologic and clinical evaluation, TRAMB administration has the potential to improve orbital salvage rates and improve versus stabilize visual acuity. Treatment complications are more likely with deoxycholate than with liposomal amphotericin formulations. The existing literature describing use of TRAMB is limited due to its retrospective nature, but the increase in IFS cases since 2020 due to the COVID pandemic has broadened the literature. CONCLUSIONS: TRAMB is an effective adjunctive treatment in IFS with mild-to-moderate orbital involvement when used in combination with standard of care debridement, systemic antifungal therapy, and immunosuppression reversal. Prospective longitudinal studies and multi-institutional randomized trials are necessary to determine the definitive utility of TRAMB.

  PublisherDOI

Frequent coauthors

• Dwight R. Kulwin

  University of Cincinnati

  87 shared

• M. Reza Vagefi

  Tufts Medical Center

  81 shared

• Davin C. Ashraf

  Oregon Health & Science University

  39 shared

• Bryan J. Winn

  University of California, San Francisco

  35 shared

• Oluwatobi O. Idowu

  AbbVie (United States)

  35 shared

• Evan Kalin-Hajdu

  Université de Montréal

  31 shared

• Linyan Wang

  Eye Center

  23 shared

• Kristin E. Hirabayashi

  23 shared

Education

• M.D.

  University of Iowa Carver College of Medicine

• Other, Ophthalmology

  University of Iowa Carver College of Medicine

• Other, Ophthalmic Plastic, Orbital, and Reconstructive Surgery

  University of Iowa Carver College of Medicine

Awards & honors

• American Academy of Ophthalmology’s Lifetime Achievement Awa…
• American Society of Ophthalmic Plastic and Reconstructive Su…
• 2021 Dortzbach Award