Gholam A. Peyman, MD, is a world-renowned ophthalmologist, retina surgeon and inventor. He has been granted well over 200 US patents covering a broad range of medical devices, intraocular drug delivery and surgical techniques, as well as new methods of diagnosis and treatment. He is probably best known for his invention of LASIK surgery for which he was awarded a US patent in 1989.
Born in Iran in 1937, Dr. Peyman moved to Germany at the age of 19. He received his medical degree from the University of Freiburg in 1962 and completed his residency in ophthalmology and a retina fellowship at the University of Essen, in 1969. He went on to complete an additional postdoctoral fellowship in retina at the Jules Stein Eye Institute, UCLA School of Medicine in 1971 where he joined the faculty as an assistant professor of ophthalmology. He went on to serve as an associate professor and then professor of ophthalmology and ocular oncology at the Illinois Eye and Ear Infirmary at the University of Illinois at Chicago between 1971 and 1987.
From 1987 to 2000, Dr. Peyman held a joint appointment at the School of Medicine and Neuroscience Center of Excellence at Louisiana State University. He also held the Prince Abdul Aziz Bin Ahmed Bin Abdul Aziz Al-Saud Chair in Retinal Diseases from 1998-2000. From 2000-2006, he served as professor of ophthalmology and co-director of the Vitreo-Retinal Service at Tulane University School of Medicine. From 2006 to 2007 he was a professor of ophthalmology at the University of Arizona, with a cross appointment in the department of Optical Sciences. He has been emeritus professor of ophthalmology at Tulane since 2009 and in more recently has been a professor of basic medical sciences at the University of Arizona College of Medicine.
Among his numerous awards Dr. Peyman has received the 2012 National Medal of Technology and Innovation. He has also been awarded the Waring Medal of the Journal of Refractive Surgery (2008), the American Academy of Ophthalmology's Lifetime Achievement Award (2008), and was named a fellow of the National Academy of Inventors in 2013.
Please share an impactful moment that shaped your career. Was there a time in your career when you witnessed history in the making?
After exploring general surgery, cardiothoracic surgery, pathology, radiology and a short period of ophthalmology with Professor Ernest Custodis, MD, I was offered a residency in ophthalmology at Essen University.
For me, the Light photocoagulation device developed by Professor Gerhard Meyer-Schwickerath, MD, Essen University in Germany, got me hooked on ophthalmology.
What career accomplishment provides you with the greatest sense ofsatisfaction?
Evaluation of blood ocular barrier with peroxidase tracer material and elucidating the effect of the thermal laser on this barrier and choroidal vessels (in 1970 with Drs. Bock, Straatsma, Spitznas, and Appleat UCLA and the University of Illinois Chicago (UIC)) taught me that medication administered systemically or injected intravenously will not reach the retina or vitreous at sufficient concentration to be effective therapeutically and that normal retinal vessels do not leak. Furthermore, a high systemic concentration of medications will have a number of systemic side effects.
I also learned that the direction of the flow of fluid in the vitreous was either through the retina towards the RPE cells barrier (unless the barrier was broken by the laser or inflammation) or anteriorly through the AC. Therefore, we did toxicity studies with various concentrations of numerous medications injected in the vitreous cavity to determine the non-toxic doses for intracameral or intravitreal administration and evaluated their efficacy in various disease processes (1971-1987 at UIC with Drs. Daily, Herbst, May, Paque, Vastine, etc.). These compounds included:
- antibiotics, dexamethasone or combination therapy(with Dr. Graham);
- anti-fungals (with Dr. Axelrod);
- antivirals for viral retinitis (with Drs. Pulido, Fiscella, and Goldberg);
- intravitreal slow-release compounds (liposomes) for retinal selective angiography, drug delivery (1985-1997 with Drs. Koobehi, Zeimer, Niesman);
- retinal blood flow measurement, intravitreal slow-release medications microspheres, polylactic glycolic acid, poly caprolactone, and biologics, immunosuppressant (with Dr. Badaro);
- laboratory and clinical investigation for prophylaxis and treatment of endophthalmitis (1975 at UIC and Eye camps in India with Drs. Paque, Meisels, and Sathar), and,
- intravitrealanti-VEGFs (2006 with Dr. Manzano at Tulane University).
Other accomplishments for which I am gratified include:
- Vertically oscillating disposable vitrectomy instrument (Vitrophage, 1969-1970);
- 23-gauge vitrectomy probe (1990);
- High-speed vitrectomy 2002 (with Dr. Livir-Rallatos);
- Ultrasonic vitrector >20,000 s.Oscillation (with Dr. Raichand,1984 and 2021);
- Endodiathermy (with Dr. Schwind and Dodich,1969-1970);
- Pars plicata approach for children (with Dr. Goldberg, 1978);
- Management of retinoschisis (with Dr. Larson in 1985);
- Endolaser (intraocular laser coagulation with Drs. Grisolano and D’Amico, 1980);
- Fluorosilcone and Perfluoroperhydrophenanthrene, Vitreon, (with Dr. Clarck, Hagazy, Wafapoor);
- Heavy fluid for retinal detachment and to unfold the giant tear (1987);
- Development of first operating microscope with stereo vision for the assistance (with Drs. Sanders and Fried, 1977), which became the basis of virtual reality in any surgery;
- Visualization of the vitreous during surgery with triamcinolone known as Triesence; Suspension (with Dr. Conway, 2000), and therapy (with Dr. Soheilian);
- Use of quantum dots alone or with CRISPR Cas 9 for retinal stimulation and gene therapy (method to regulate polarization of excitable cells, 2005 and 2015);
- Retinal biopsy (with Dr. Fishman) external and internal removal of intraocular tumors; Von Hippie Lindau disease (with Drs.Juarez and Kertes, Lipa, 1972-2000);
- Photodynamic therapy (SnET2) (with Drs. D. Moshfeghi, A. Moshfeghi, Yoneya, and Mori);
- Retinal pigment epithelium transplantation (with Drs. Blinder, Desai, and Alturki, 1991);
- Development of the first glaucoma shunt (with Drs. May and Erickson, 1974);
- LASIK surgery (with Dr. Badaro, Viherkoski, and Beyer,1985-1989);
- Photo-ablatable corneal implant (with Drs. Arosemana, Beyer, and Friedlander, 2005);
- Corneal inlay crosslinking (2008-2022);
- Teledioptric IOL for ARMD (with Dr. Koziol, 1988);
- UV-absorbing pseudophakos (with Dr. Sloan, 1982-83);
- New IOLs for refractive surgery (with Dr. Arbisser,2020);
- Intravitreal anti-VEGF (with Dr. Manzano, 2006);
- inflammatory cell pathway inhibitors Rock inhibitors for wet and dry ARMD, with or without slow-release polymers (2008-2022);
- Treatment of viral infection, including the coronaviruses (2021);
- Remote laser delivery system and dynamic facial recognition telemedicine (2022).
- Controlled (external or internal) thermotherapy, simultaneous imaging and thermometry for cancer therapy and immunotherapy at Ryerson University in Canada (with Drs. Tawakkoli, Kolios, Kumaradas, 2019-2022);and,
- Invention of fluidic lenses and new automatic objective phoropter and camera a new light field camera at University of Arizona (with Drs. Peyghambarian, Schwiegerling, and Blanche, 2006-2022).
One of my other sources of pleasure has been introducing vitrectomy instruments to my colleagues at Aravind Hospital in India, including Drs. Venkataswamy, Numparomalsamy and Badrinath. The medical schools in India teach ophthalmology based on a three-volume book I published with Drs. Sanders and Goldberg entitled, Principles and Practice of Ophthalmology (1980-2000).
What do you feel is the most significant development or change in the practice of retina?
There are a few, including laser coagulation, imaging systems such as OCT, wide field camera, intravitreal drug delivery for management of retinal diseases and endophthalmitis, as well as vitrectomy, gene therapy, tele-ophthalmology and artificial intelligence.
Can you share any advice to future generations of retina specialists?
Follow your dream.
Ophthalmology is a beautiful field of the medicine on many levels. For me, it offered unimagined areas of discovery, engineering, surgery, genetic engineering, medicine and optical sciences.
I was lucky to get a good start working with generous, enthusiastic people such as Drs. Morton Goldberg, Lee Jampol, Manus Kraff, Don Sanders, and Mandi Conway at UIC, Louisiana State University (LSU) and Tulane University, as well as Dr. Delmar Caldwell and hundreds of exceptional fellows from the United States and across the world. I have been fortunate to work with Dian Robinson at UIC and Julie Acosta at Tulane, as well as my book co-authors Drs. Goldberg, Sanders, Apple, Schulman, Conway, Meffert, and Lee.
I am a member of Hall of Fame of ASCRS. Unexpectedly, in 2013, I received National Medal of Technology and Innovation from President Obama for, “Invention of LASIK surgery, development of intraocular drug delivery and expanding the field of vitreoretinal surgery.” I also received the Gold Medal of Ophthalmology from the Iranian Ophthalmological Society and an honorary Doctorate of Medicine from the University of Cordoba/Argentina (2014).
I have 220 U.S. patents, as well as some international patents on both ophthalmic and non-ophthalmic subjects, including cancer therapy, optical instruments, such as telescope, camera, light field camera, fluidic lenses, an objective phoropter, and remote laser delivery system.
I apologize that for the lack of space, I cannot mention all those to whom I owe the debt of gratitude for their collaboration in my academic career.
How do you imagine the practice of retina will change by 2040?
There will be a lot of new discoveries and progress in genetic engineering and nanotechnology that can change the field of ophthalmology far beyond what we know now. Beyond this, I hope we survive the future wars, the climate change, and viral pandemics, “the sure things.”
Our thanks to Dr. Peyman for sharing his retina reflections.
(Retina Reflection published 2022)
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