NEWSLETTER - SUMMER 2002
|Dr. Liz Davis, Dr. Fine's
incoming president Dr. MacDonald and
ASCRS past president Dr. Fine.
This year's international symposium of the American Society of Cataract
and Refractive Surgery held in Philadelphia was in many ways an unveiling
of the extent and excellence of the clinical research being done in
our practice. Our three physicians, Drs. Fine, Hoffman, Packer, and
our fellow, Dr. Tarek Mo-hamed from the Assiut University Hospital
in Egypt, gave fifty different presenta-tions of new phacoemulsification,
intraocular lens and refractive surgery technol-ogy, technique and
Our practice is currently involved in nine FDA-monitored clinical
studies to verify the efficacy of a variety of different technologies.
We have procedures and modalities that are enormously superior available
to our patients, sometimes years in advance of their general availability,
because we only investigate tech-nologies that have apparent major
At the annual meeting, we were approached by several new manufactur-ers
of cutting-edge technologies, many of which looked extremely appealing,
as a result of the presentations that we gave at the symposium. We
will be com-mencing investigational work with these new technologies
in the very near future. Some of these studies, including new treatments
for pediatric cataracts and higher refractive errors, promise to be
enormously advantageous for patients with combined glaucoma and cataract.
It really is an exciting time for our practice, as well as for our
patients, and in many ways we are moving into a golden age in ophthalmology.
We have never had so much to offer our patients, and the new technology
just over the horizon looks very promising. We are seeing advances
so beneficial that we can't help but be very optimistic about addressing
the refractive surgery goals of our patients in the future, in addition
to improving the existing modalities for visual rehabilitation after
We were delighted to receive an award at the ASCRS Film Festival
for a film we produced on new phacoemulsification modalities. The
film was a ten-minute video that showed footage of all of the new
investigational and recently approved cataract surgery technologies
which have minimized the invasiveness of cataract surgery, and maximized
the level of immediate postop visual reha-bilitation.
|Laurie receives the Pinnacle
Award from Ann Rose.
In addition to our practice's film award, I was personally delighted
to have been nominated and elected to the position of Secretary of
the International In-traocular Implant Club (IIIC). The IIIC was chartered
in the early 1950s, when early pioneers in intraocular lens implant
surgery from around the world gathered together to share experiences,
and share information for benefit of their patients. Many of these
physicians were looked upon as rogues within the profession at that
time, but their ideas and their persistence in pursuing the best interest
of their patients has benefited cataract surgery patients worldwide.
The current IIIC is a legacy from these early pioneers, and now represents
a handful of ophthal-mologists from each country around the world
with a total membership of almost 200 eye surgeons. I consider it
an honor and a privilege to be elected to the Ex-ecutive Committee
of the IIIC.
A final accolade our practice received was the bestowing of the William
E. Rose, Jr. Pinnacle Award on Laurie Brown, COMT, COE, our administrator.
This award, given by the American Society of Ophthalmic Administrators,
recognizes excellence in developing and implementing exemplary policies
and guidelines to help protect the practice from erroneous or fraudulent
billing practices and main-taining compliance with government regulations.
We are very proud of our entire staff, and we are delighted that our
practice is a leader in proper business prac-tices, as well as in
the medical and surgical aspects of ophthalmology. [ top ]
Researchers have discovered that eye drops used to treat
elevated pressure inside the eye can be effective in delaying the
onset of glaucoma. These results mean that treating people at higher
risk for developing glaucoma may delay -- and possibly prevent --
the disease. These findings are reported in the June 2002 issue of
Archives of Ophthalmology.
|Mark Packer, M.D
Scientists found that pressure-lowering eye drops reduced by more
than 50 percent the development of primary open-angle glaucoma,
the most common form of glaucoma and one of the nation's leading
causes of vision loss. Researchers noted that 4.4 percent of the
study participants who received the eye drops developed glaucoma
within five years. By comparison, 9.5 percent of the study participants
who did not receive the eye drops developed glaucoma. Additionally,
several significant risk factors were found to be associated with
the development of glaucoma in study participants. These included
personal risk factors, such as older age and African descent, as
well as ocular risk factors, such as higher eye pressure, certain
characteristics in the anatomy of the optic nerve, and thinness
of the cornea.
The study -- called the Ocular Hypertension Treatment Study --
examined 1636 people 40-80 years of age who had elevated eye pressure
but no signs of glaucoma. Half were assigned daily eye drops, and
the other half were assigned to observation (no medication). In
the medication group, treatment reduced eye pressure by approximately
Open-angle glaucoma affects about 2.2 million Americans age 40
and over; another two million may have the disease and don't know
it. Glaucoma occurs when the optic nerve is damaged. In most cases,
increased pressure in the eye plays an important role in this damage.
The damage to the optic nerve causes loss of peripheral (side) vision.
As the disease worsens, the field of vision gradually narrows and
blindness can result. However, if detected early through a comprehensive
eye exam, glaucoma can usually be controlled and serious vision
loss prevented. Comprehensive eye examinations are recommended for
all people over age 60, and African Americans over age 40.
In the light of this new information from the Ocular Hypertension
Treatment Study, we may wish to revisit the decision of whether
or not to treat eyes with elevated intraocular pressure but no nerve
damage from glaucoma.
Endoscopic cyclophotocoagulation (ECP) represents a new surgical
modality in the fight against glaucoma. Peformed during or after
cataract surgery, this procedure involves laser treatment of the
part of the eye that makes the aqueous humor (watery fluid inside
the eye). After treatment, the rate of fluid production is reduced,
thus decreasing the intraocular pressure. At the recent meeting
of the American Society of Cataract and Refractive Surgeons in Philadelphia,
investigators presented a review of one thousand laser procedures,
demonstrating an outstanding safety profile and a very high success
rate, with an average reduction in pressure by over 50 %.
The most elegant feature of this procedure lies in the technological
feat of combining a high resolution endoscope, light source and
a laser device within a tiny microsurgical probe. At the time of
cataract surgery it takes only a few extra minutes to image and
treat the ciliary epithelium that produces the aqueous humor. Investigators
found that the treatment allowed glaucoma patients to decrease the
number of eye drops they used to control pressure from an average
of 3.6 medications to just over 1. Patients who have already had
cataract surgery are also eligible for this procedure, which is
performed on an outpatient basis under topical anesthesia.
Increasing understanding and options for both medical and surgical
treatment of glaucoma are good news for patients who might otherwise
continue to lose vision and face eventual blindness. Together we
can work to defeat preventable blindness in our lifetime. [ top ]
One of the fastest growing forms of refractive surgery in
our practice is a procedure termed a refractive lens exchange with
a multifocal intraocular lens implant. A refractive lens exchange
involves the removal of the human crystalline lens and insertion of
an intraocular lens implant to reduce or eliminate the eye's refractive
error. By inserting a multifocal lens, the majority of eyes can see
at distance and near without the need for glasses. Astigmatism can
be addressed at the time of the procedure by placing relaxing incisions
in the peripheral cornea or in special instances, a special lens implant
with astigmatism correction built into the lens can be inserted and
oriented to reduce the refractive astigmatism.
| Richard S. Hoffman,
Currently, the only multifocal intraocular lens that is FDA approved
for use within the U.S. is the AMO Array. The Array has five concentric
zones on its front surface that have all of the desired refractive
powers within them and are designed to allow for distance and near
The surgical procedure is the same technique we utilize with our
cataract patients differing only in that the crystalline lens is
clear and not cataractous. The procedure is performed under topical
anesthesia without injections and without stitches. Patients who
are farsighted and presbyopic (unable to see up close or far away)
are the best candidates for this procedure, however, we have also
performed this technique in nearsighted patients with great success.
Patients interested in learning more about refractive lens exchange
should contact Tony Reynolds at 541-687-2110 to receive more information
and to schedule a complimentary screening to determine if they are
a good candidate for this procedure. [ top ]
are very proud of our technicians' latest certification accomplishments!
This year Sue Stuhr achieved her Certified Ophthalmic Technician
credential by passing both a skill evaluation and written exam.
Amber Hargreaves was awarded the Certified Ophthalmic Assistant
credential after successfully passing her written exam.
Established in 1969, JCAHPO is an international nonprofit corporation
that certifies and provides continuing education opportunities
to ophthalmic allied health professionals. JCAHPO is accredited
by the National Commission for Certifying Agencies (NCCA). Their
mission is to "Enhance the quality and availability of
ophthalmic patient care by promoting the value of qualified
allied health personnel and by providing certification and continuing
education." [ top ]
the young age of 81, my eyes were giving me trouble. I went
to see a local ophthalmologist to see what was wrong. I was
very unhappy with that experience and decided to get a second
opinion. An ophthalmologist in California told me I had a world-renowned
ophthalmologist very near me in Oregon. I immediately made an
appointment. Five minutes with Dr. Fine and I knew I had the
After a very thorough examination, he told me
he would take one cataract out this week and the other one next
week. To my great and happy surprise, there were no stitches,
no patches and no restrictions on my activities. Two days later
I played golf. The following week the second cataract was out
and, the greatest thing of all, Dr. Fine had given me 20/20
vision! I used to ask my golfing partner, "Where did my
ball go?" Now he asks me where his ball went.
I cannot thank Dr. Fine and his very wonderful
and courteous staff enough for all the help and kindness they
have given me. In my book there is only one ophthalmologist
to see if you have any eye trouble, and that's Dr. Fine! [ top ]