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Drs. Fine, Hoffman & Sims Opthalmologists in Eugene Oregon

NEWSLETTER - SUMMER 2002

Highlights

Leadership for Drs. Fine, Hoffman and Packer
By Dr. I. Howard Fine, M.D.
Dr. Liz Davis, Dr. Fine's goddaughter, ASCR
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 instrumentation.

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 advantages.

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 cataract surgery.

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 ]


"Glaucoma: New Information, New Procedure"
By Mark Packer, M.D.

Mark Packer, M.D
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.

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 20 percent.

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 ]


Refractive Lens Exchange Growing In Popularity
By Richard S. Hoffman, MD

Richard S. Hoffman, M.D.
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.

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 viewing.

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 ]


Congratulations!

We 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 ]


“A Happy Surprise”
by D. Grey Found

At 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 right doctor.

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 ]


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Physical Address:
1550 Oak St., Suite 5
Eugene, OR 97401

Phone Numbers:
1-800-452-2040
ph: 541-687-2110
fax: 541-484-3883

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