I
REDISCOVERING THE JOY OF TEACHING
When I started my private practice in 1992, I became a gratis
faculty member with the University of Louisville Department of
Ophthalmology. Having recently completed my training with the
Department, I felt that it was important to stay in touch with the
residents, assisting with emergency care and proctoring cataract
surgery. As time progressed, my practice became busier. Thus, I
became less available to assist the residents in surgery, but I kept
a relationship with the Department by attending Grand Rounds and
various lectures. Over the years, I found that I missed the one-on-
one interaction with residents in the operating room.
Early in 2018, one of my colleagues and former attending physi-
cians, Dr. Richard Eiferman, approached me about an opportunity
to begin teaching the University of Louisville Ophthalmology Res-
idents refractive surgery, specifically Photorefractive Keratectomy
(PRK) and LASIK. Dr. Eiferman had been in discussions with
Johnson & Johnson Vision to support training of the residents at
our Suburban Excimer Laser Center. Our laser center is located
at Suburban Medical Plaza #1 next to Norton Suburban Hospital.
The center began operations in 1996 when 13 physicians, including
myself, came together to form a private group to purchase an Exci-
mer laser so we could begin performing retractive surgery. In the
early years, PRK was the primary procedure. When LASIK became
more popular a few years later, the group invested in the additional
necessary equipment. Eventually, we purchased a femtosecond laser
in order to perform LASIK without a blade which made the proce-
dure much safer and more predictable. There have been numerous
improvements and upgrades to the equipment and procedure so
that now it can be entirely customized for the individual patient
producing excellent results.
When we were approached by J&J Vision, there was only one
other ophthalmology program in the country that they were sup-
porting to train residents in refractive surgery, the prestigious
Wills Eye Hospital in Philadelphia. Because our laser center owned
J&J lasers and had a teaching relationship established with UofL
Department of Ophthalmology through Dr. Eiferman, we were
in an ideal position to provide refractive surgery training to the
residents. To establish the training program, Dr. Eiferman, Dr.
Mark Cassol and I were required to become certified instructors
with J&J. Following our formal training, we began taking the UofL
residents through the requisite steps for LASIK certification. Prior
4
LOUISVILLE MEDICINE
to performing their first cases, they were required to register online
with J&J, attend three lectures covering the basics of laser technology
and finally take part in a wet lab with a certified J&J technician.
Following these steps, the residents were ready to schedule their
first cases. Dr. Eiferman had been working with the residents at the
Department for some time and helped the residents screen patients
in the eye clinic at UofL. Because of J&J’s support, the residents were
able to offer the surgery to patients at a significant discount. Dr.
Cassol and I served as LASIK proctors. The first cases took place in
May of 2018. Two residents, Dr. Tala Kassm and Dr. Mark Mugavin,
became LASIK certified in June of last year, having completed the
required 10 procedures prior to their graduation from the UofL
Residency program.
To date, six more residents at UofL have become certified to
perform LASIK making the UofL program one of the most success-
ful training programs in the country. At the recent Fall Meeting of
the Kentucky Academy of Eye Physicians and Surgeons, Dr. Kevin
Lowder, a current third year resident at UofL, presented the initial
results of the Refractive Surgery Training Program. The excellent
results are shown in Figure 1. Complication rates have been very
low. A survey has been completed by patients showing very high
satisfaction rates. Due to the success of the UofL program, J&J has
extended their support of the refractive surgery training program
to the University of Kentucky Department of Ophthalmology. Two
UK residents have recently completed their initial LASIK cases at
our center.
My involvement with the UofL and UK Refractive Surgery
Training Programs has been most enjoyable. I had forgotten how
much satisfaction there is in training residents. To see the excitement
that the residents experience by learning a new procedure that most
programs in the country do not even offer has been very fulfilling. I
look forward to continuing this program which provides residents
with an invaluable skill they can carry into the next step of their
medical careers. As senior and seasoned physicians involved in the
training of our newly minted young colleagues, we are constantly
reminded of how we can make a difference in their professional
development.
Dr. Burns is a private practice ophthalmologist. His practice, Middletown Eye Care,
is located in Middletown, KY.