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Posted by Lasik Eye Surgery | Category:Dr. Stephen Slade, eye surgeon, eye surgery, laser eye surgery, laser vision correction, laser vision surgery, lasik
Ophthalmologist
Dr. Stephen Slade was the first surgeon in the United States to perform LASIK eye surgery and also has the longest experience with Bladeless LASIK or LASIK performed with two lasers including one to make the flap. Dr. Stephen Slade has extensive experience and has performed LASIK and other types of refractive surgery on more than 25,000 patients from Houston and around the world. More recently, Dr. Stephen Slade performed the first Laser Cataract Surgery procedure in the United States, setting a new standard in cataract care. LASIK eye surgery pioneer Dr. Stephen Slade, MD, FACS is a Houston, Texas native who is a specialist in vision correction procedures. Patients from all around the world seek the professional ophthalmology and LASIK eye surgery services of Dr. Stephen Slade.
The following article was written by Dr. Stephen Slade:
Innovation, Industry and the Private Practice Ophthalmologist
The private practice sector of ophthalmology, in partnership with industry, is the most powerful driver of innovation in our specialty. The list is almost too long to cite; from Charles Kelman to phacoemulsificiation; Barraquer, Buratto, Brint and LASIK; even the excimer laser itself came from a partnership with industry—IBM. Can you imagine the practice of cataract and refractive surgery today meant to be the actual speciality not the journal, for example, if we did not have any of the innovations stemming from the partnership between the private sector and industry? These gifts include posterior chamber IOLs, clear corneal incisions, topical anesthesia, and so many other surgical techniques and instruments. The very way we manage and conduct our practices heavily influenced by the private sector and our industry partnerships. Think of Ambulatory Surgery Centers, marketing, patient education, and I don’t need to list all of the recent cosmetic advancements.
There is little wonder that there is such a long list of innovations from the teaming of private sector with industry. Our practices depend upon these advances. The eye itself demands technology and innovation; the surgery is challenging and has to be delicate and elegant. The instruments are minute, and we are always pushing limits as a routine. We can’t even see much of what we do in the OR without technology. We require superb bio and operating microscopes. Where would ophthalmologic diagnosis and treatment be without all of the other imaging technologies such as optical coherence tomography, ultrasound, topography, and wavefront analysis? This is at the core of why I went into ophthalmology. I was fascinated by how precisely you could quantify your postoperative results—and your own skill level— in terms of 20/20, 20/30, etc. You can’t do that with gall bladder surgery. New diagnostic technology allows us to even further grade ourselves so that we may constantly improve our surgery. Even in a business sense, what other medical specialty or even any small business man has such a heavy investment in capital equipment as the ophthalmologist with his excimer or two, a femtosecond laser, multiple diagnostic instruments, and a few lanes of equipment. Some of us spend more on technology than we do on our homes!
And certainly no specialty has more toys. I knew I was in the right place as soon as I started practice and learned myopic keratomileusis (MKM). MKM was the first example in medicine of taking a part of the human body and modifying it to function better than ever using computers and technology. I was hooked. Although my early mentors were university based like Kaufman and Koch, I owe much of what I do today to private practice surgeons including Barraquer, Buratto, Brint, and Nordan, who were all more than willing to share with me. Indeed the private sector has always shared and taught innovation and technique, from industry based LASIK courses to huge educational meetings like ASCRS. Our professional societies and educational meetings are largely funded from private practice eye surgeons and industry. In fact, our largest professional society in cataract and refractive surgery, ASCRS, was organized, and has largely been led by, private sector ophthalmologists.
When I think of what I do on a daily basis in my practice, most of the innovations, most of what I use, has come from the private sector. And typically these innovations are developed with a forward thinking industry. Yes, they are profit driven. Years ago though, I realized as long as industry was plowing back substantial percentages, and they are, into research and development, they will provide us with the tools we need to improve.
What drives this ability for investment return? First, as cataract surgery is the number one expenditure in medicine, is our ability to be reimbursed fairly for premium IOLs. The Centers for Medicare and Medicaid Services (CMS) ruling on May 11, 2005—spearheaded by J. Andy Corley, Corporate Vice President and Global President, Surgical Products, Bausch & Lomb—authorized the current market- and work-based fee schedule. The first premium IOL available in the United States was developed by a private practice ophthalmologist in partnership with industry, the Crystalens (previously Eyeonics, Inc., Aliso Viejo, CA; now Bausch & Lomb, Rochester, NY), which received US FDA approval on November 13, 2003. Today the Crystalens is the most commonly used premium lens in the United States and, as recently as 2009, it was thought to represent more than 50% of all premium lenses used in the United States. Second is our freedom with so many elective, patient-pay procedures; LASIK, PRK, even contact lenses and glasses. Our field remains attractive to invesment. Mergers and acquisitions of major ophthalmology companies, eg, AMO, Bausch & Lomb, Visx, Intralase, are plentiful. This provides venture companies with the ability to generate the kind of multiples they need to attract new capital.
Private practice ophthalmology and industry have driven innovation through the highest levels of scrutiny and proof as well. Currently I am working with industry and the FDA on femtosecond laser refractive cataract surgery, new accommodating IOLS, new pharmaceuticals, corneal approaches to presbyopia, and topography-guided LASIK. Indeed, most investigators for the majority of the FDA trials I have participated in have been in private practice and the trial itself sponsored by industry. After the FDA, there is no higher test than the real world of private practice with hundreds of surgeons performing thousands of cases.
Yet much more innovation is needed. Our patients need artificial retinas, a cure and reversal for age-related macular degeneration and glaucoma. Can we create better vision than what we were born with? Why not a wider field, sharper acuity, extended color vision? More mundane but pervasive, why must we wear reading glasses after a lifetime of glasses-free vision? I believe we are coming into the best time ever for ophthalmology driven by the maturation of the baby boomers with their eye care needs. Currently there are 76 million of us boomers—those born between 1946 and 1964—and our numbers will double in 10 years. My group will not go gently into that good night. We will demand increased care, new cures, avoidance of aging and more technology, especially with our most important sense, our sight. Innovation, industry, and the private practice ophthalmologist; how could you ever separate them?
Stephen G. Slade, MD, is a surgeon at Slade and Baker Vision in Houston. Dr. Slade may be reached at (713) 626-5544; sgs@visiontexas.com.
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