Gholam A. Peyman
Encyclopedia
Gholam A. Peyman, MD is a Hall of Fame of Ophthalmology
Ophthalmology
Ophthalmology is the branch of medicine that deals with the anatomy, physiology and diseases of the eye. An ophthalmologist is a specialist in medical and surgical eye problems...

 and retina
Retina
The vertebrate retina is a light-sensitive tissue lining the inner surface of the eye. The optics of the eye create an image of the visual world on the retina, which serves much the same function as the film in a camera. Light striking the retina initiates a cascade of chemical and electrical...

 surgeon who is also a prolific and successful inventor. Gholam Peyman has, thus far, been granted 124 US Patent
Patent
A patent is a form of intellectual property. It consists of a set of exclusive rights granted by a sovereign state to an inventor or their assignee for a limited period of time in exchange for the public disclosure of an invention....

s covering a broad range of novel medical devices, intra-ocular drug delivery, surgical techniques, as well as new methods of diagnosis and treatment. His most widely-known invention to date is LASIK
LASIK
LASIK or Lasik , commonly referred to simply as laser eye surgery, is a type of refractive surgery for correcting myopia, hyperopia, and astigmatism...

 eye surgery, a vision correction procedure designed to allow people to see clearly without glasses. He was awarded the first US patent for the procedure in 1989 (link to image of patent, below). In addition to the numerous other honors and awards he has received (please see section 4, for Publications and awards), in 2005 he was selected by a ballot among the more than 30,000 ophthalmologists around the world to become one of the thirteen living ophthalmologists inducted into the Hall of Fame of Ophthalmology
Ophthalmology
Ophthalmology is the branch of medicine that deals with the anatomy, physiology and diseases of the eye. An ophthalmologist is a specialist in medical and surgical eye problems...

.

Life and career

Peyman was born in Iran
Iran
Iran , officially the Islamic Republic of Iran , is a country in Southern and Western Asia. The name "Iran" has been in use natively since the Sassanian era and came into use internationally in 1935, before which the country was known to the Western world as Persia...

. At the age of 19, he moved to Germany
Germany
Germany , officially the Federal Republic of Germany , is a federal parliamentary republic in Europe. The country consists of 16 states while the capital and largest city is Berlin. Germany covers an area of 357,021 km2 and has a largely temperate seasonal climate...

 to begin his medical studies. He received his MD
at the University of Freiburg
University of Freiburg
The University of Freiburg , sometimes referred to in English as the Albert Ludwig University of Freiburg, is a public research university located in Freiburg im Breisgau, Baden-Württemberg, Germany.The university was founded in 1457 by the Habsburg dynasty as the...

 in 1962. He completed his internship at St. Johannes Hospital in Diusberg, Germany in 1964 and at
Passaic General Hospital in Passaic, New Jersey
Passaic, New Jersey
Passaic is a city in Passaic County, New Jersey, United States. As of the 2010 United States Census, the city had a total population of 69,781, maintaining its status as the 15th largest municipality in New Jersey with an increase of 1,920 residents from the 2000 Census population of 67,861...

 in 1965.
Peyman completed his residency in ophthalmology and a retina fellowship at the University of Essen, Essen Germany, in 1969 and an additional postdoctoral fellowship in retina at the Jules Stein Eye Institute
Jules Stein Eye Institute
The Jules Stein Eye Institute, founded by MCA founder Jules Stein, functions as the department of ophthalmology for the UCLA David Geffen School of Medicine.-References:...

, UCLA School of Medicine in Los Angeles in 1971.
Peyman held the position of Assistant Professor of Ophthalmology at the UCLA School of Medicine from 1971 and served as Associate Professor and then Professor of Ophthalmology at the Abraham Lincoln School of Medicine, University of Illinois at Chicago
University of Illinois at Chicago
The University of Illinois at Chicago, or UIC, is a state-funded public research university located in Chicago, Illinois, United States. Its campus is in the Near West Side community area, near the Chicago Loop...

 during 1971-1987.
Peyman held a joint appointment at the School of Medicine and also at the Neuroscience Center of Excellence at the Louisiana State University Medical University Medical Center in New Orleans during 1987-2000. During 1998-2000 Peyman held the Prince Abdul Aziz Bin Ahmed Bin Abdul Aziz Al Saud Chair in Retinal Diseases. During 2000-2006, Peyman served as Professor of Ophthalmology and Co-Director, Vitreo-Retinal Service, Tulane University School of Medicine in New Orleans.
During 2006-2007 he was Professor of Ophthalmology at the University of Arizona, Tucson with a cross appointment at University of Arizona Optical Sciences. He has been emeritus Professor of Ophthalmology at Tulane University since 2009.
Peyman is currently Professor of Basic Medical Sciences at the University of Arizona, Phoenix & Optical engineering at U.A. Tucson AZ.

The Invention of LASIK Surgery and its improvements: In 1977, because of his interest in the effects of lasers on tissues in the eye, Peyman began evaluating the potential use of a CO2 laser to modify corneal refraction in rabbits. No prior study had existed on this concept. The laser was applied to the surface of the cornea using different pattens. This laser created significant scarring. His conclusions at that time were: 1) one has to wait for the development of an ablative laser and 2) one should not
ablate the surface of the cornea but, instead, the ablation should take place under a flap in order
to prevent scarring, pain and other undesirable sequelae. Peyman published the first article on this subject in 1980. In 1982, he read an article from Bell Laboratories, published in Laser Focus, describing the photo-ablative properties of an excimer
laser on organic material. This was very exciting information, but, unfortunately, Peyman did not have access to this laser, which at the time was new and very expensive By 1985 and beyond, many investigators were interested in ablating the corneal surface.
However, because of his previous experience with the CO2 laser, Peyman wanted to avoid surface ablation in order to prevent potential corneal scarring and the pain associated with the removal of the corneal epithelium, necessary to expose the surface of the cornea. Therefore, in July 1985, he applied for a patent that described a method of modifying corneal refractive errors
using laser ablation under a corneal flap (please see Figure 1). This US patent was accepted after two revisions and issued in June, 1989.
Peyman performed a number of experimental studies evaluating the effect of various excimer lasers in collaboration with Physics Department of the University of Helsinki, Finland. Since he had purchased an Erb-Yag laser in the U.S., he evaluated the concept using this laser in vivo in rabbit and primate eyes and described the creation of a hinged corneal flap to enable the
ablation to be performed on the exposed corneal bed, thus reducing the potential for postoperative scarring and pain.
Improvements to LASIK Surgery: Inlays: Always aware of the potential limitations of his invention, Peyman devoted considerable time and effort in subsequent years to ameliorating them. In order to improve the risk/benefit considerations of the LASIK procedure, he invented and patented a broad range of ablative and non-ablative inlays to be placed under the surgically
created corneal flap. These inlays offered many potential advantages over the standard LASIK technique, the most significant of which is that the inlay procedure is reversible.
Improvements to LASIK Surgery: Accelerating the Return of Corneal Sensitivity Creating the surgical flap that enables the LASIK procedure necessarily cuts corneal nerves, leaving the surface of the cornea insensitive for many months following the LASIK procedure. This is a potential risk for the patient in several ways. For example the surface of the eye could be scratched and
damaged without the patient realizing this, sometimes leading to an infection that has serious consequences. Peyman evaluated the application of topical cyclosporine to the cornea prior and postsurgery in LASIK patients in order to address this problem. He was able to convincingly demonstrate in a controlled clinical study that its use dramatically accelerates the return of
corneal sensitivity after LASIK surgery when compared to the contra-lateral control eye (which received LASIK surgery but not cyclosporine). In 2008 Peyman was awarded the Waring medal by a leading peer-reviewed ophthalmology journal for this breakthrough invention (please also see 4 Publications and awards).
Figure 1. Dr. Peyman's patent was the first to describe what has become one of the most popular and effective elective
surgical procedures in history: Laser-Assisted In situ Keratomileusis, more commonly known as LASIK surgery.

Other Inventions and patents

Peyman's inquiring mind, coupled with his keen interest in engineering and pharmacology along with his in-depth background and experience in ophthalmology resulted, over a 40-year period, in a remarkable range of novel devices, improvements in surgical methods and revolutionary new treatment methods and modalities.
A partial list of Peyman's most significant discoveries and inventions (with first publication date), many of which are still in use today, includes:
  • Modifications and improvements to the operating microscope (1972, 1974 and 1977)
  • Vitrectomy instruments and techniques - Techniques of vitreous removal (1971, 1972)
  • Vitreous scissors and forceps (1975)
  • The vitrophage (1976, 1977)
  • Improved vitrectomy illumination system (1976)
  • Wide-angle cutter vitrophage (1976)
  • Miniaturization of the vitrophage (1980)
  • A bent-.pped vitrophage for anterior segment surgery (1982)
  • An illuminated air-fluid switch for vitrectomy (1988)
  • A miniaturized vitrectomy system (23 gauge) for vitreous and retinal biopsy (1990)
  • A pneumovitrector for diagnostic biopsy of the vitreous (1996)
  • A new high-speed pneumatic vitrectomy cutter (2002)
  • Small-size pediatric vitrectomy wide-angle contact lens (2003)
  • A new, non-contact wide-field viewing system for vitreous surgery (2003)
  • Endolaser for vitrectomy - Intraocular photocoagulation with the argon-krypton laser (1980)
  • Argon endolaser (1981)
  • A microscope filter for endophotocoagula.on (1981)
  • Protective eye filters for endolaser therapy (1986)
  • Special short needles to inject and aspirate high-viscosity sililcone oil (1986)
  • Contact lenses for Nd-YAG application in the vitreous (1984)
  • A new contact lens for Nd:YAG laser capsulotomy (1986)
  • An automatic laser filter for the indirect ophthalmoscope (1987)
  • A bent-tipped endolaser probe (1987)
  • An endolaser probe with aspiration capability (1992)
  • Vitreous subs8tutes - Evalua.on of perfluourocarbon gases in the vitreous (1973)
  • Use of fluorosilicone to unfold a giant retinal tear (1987)
  • Injection of fluorosilicone oil and pars plana vitrectomy for complex retinal detachment (1987)
  • Experimental evaluation of perfluorophenanthrene as a high specific gravity vitreous substitute (1989)
  • Perfluorocarbon liquids in ophthalmology (1995)

Eye wall resection (tumors) and biopsy
  • Full thickness eye wall resection (1972)
  • Local excision of choroidal malignant melanoma: Full thickness eye wall resection (1974)
  • Biopsy of human scleral-chorioretinal tissue (1975)
  • Ab interno resection of uveal melanoma
  • Histopathology of Goldmann-Favre syndrome obtained by full-thickness eye-wall biopsy (1977)
  • Treatment of large von Hippel tumors by eye wall resection (1983)
  • Internal retinal biopsy: Surgical technique and results (1990)
  • Surgical and pharmaceutical treatments for bacterial endophthalmitis(numerous publications 1973-1982)
  • Pressure-controlled shunt for glaucoma - An experimental "aqueous shunt" for the regulation of intraocular pressure. (1974)
  • Experimental evaluation of a posterior drainage system. (1983)
  • The first ultraviolet light-absorbing - Ultraviolet light absorbing pseudophakos (1982)


Intraocular drug delivery
  • Intravitreal antineoplastic (cancer) - Toxicity of antineoplastic drugs in vitrectomy infusion fluids (1983 and 1984)
  • drugs Combination intravitreal therapy - Bacterial endophthalmitis: Treatment with intraocular injection of gentamicin
    Gentamicin
    Gentamicin is an aminoglycoside antibiotic, used to treat many types of bacterial infections, particularly those caused by Gram-negative organisms. However, gentamicin is not used for Neisseria gonorrhoeae, Neisseria meningitidis or Legionella pneumophila...

     and dexamethasone
    Dexamethasone
    Dexamethasone is a potent synthetic member of the glucocorticoid class of steroid drugs. It acts as an anti-inflammatory and immunosuppressant...

     (1974)
  • Toxicity of antibio.c combinations for vitrectomy infusion fluid (1979)
  • Toxicity of antineoplastic drug combinations in vitrectomy infusion fluid (1984)
  • In vitro evaluation of cellular inhibitory potential of various antineoplastic drugs and dexamethasone (1985)
  • Proliferative vitreoretinopathy and chemotherapeutic agents (1985)
  • Effects of selected repeated intravitreal chemotherapeutic agents (1985)
  • Toxicity and clearance of a combination of liposome-encapsulated ganciclovir and trifluridine (1989)
  • Intravitreal effects of antiviral drugs - Toxicity of intravitreal antiviral drugs (1984)
  • Vitrectomy and intravitreal antiviral drug therapy in acute retinal necrosis syndrome. Report of two cases. (1984)
  • Parenterally-administered acyclovir for viral retinitis associated with AIDS (1984)
  • Intravitreal toxicity of hydroxyacyclovir (BW-B759U), a new antiviral agent (1985)
  • Retinal toxicity of ganciclovir in vitrectomy infusion solution (1987)
  • Toxicity of intravitreal injection of foscarnet in the rabbit eye (1988)
  • Retinal toxicity of 6-methoxypurine arabinoside (Ara-M): A new selective and potent inhibitor of varicella-zoster virus (1992)
  • Intravitreal immunosuppressants - Retinal toxicity study of intravitreal cyclosporine (1986)
  • Liposome-bound cyclosporine: Retinal toxicity afer intravitreal injection (1988)
  • Ocular toxicity of intravitreal tacrolimus (2002)
  • Slow release ocular drug delivery - Intravitreal liposome- encapsulated gentamicin in a rabbit model: Prolonged therapeutic levels (1986)
  • Liposome- encapsulated 5-fluorouracil in the treatment of proliferative vitreoretinopathy (1988)
  • Intravitreal liposome-encapsulated drugs: A preliminary human report (1988)
  • Clearance of sodium fluorescein incorporated into microspheres from the vitreous after intravitreal injection (1991)
  • Clearance of microsphere-entrapped 5-fluorouracil and cytosine arabinoside from the vitreous of primates (1992)

Laser in Ophthalmology

  • First attempt to correct refractive - Modification of rabbit corneal curvature with use of carbon dioxide laser burns (1980)
  • errors using lasers Evaluations of laser use in ophthalmology - Histopathological studies on transscleral argon-krypton laser coagulation with an exolaser probe (1984)
  • Comparison of the effects of argon fluoride (ArF) and krypton fluoride (KrF) excimer lasers on ocular structures (1985)
  • The Nd:YAG laser 1.3µ wavelength: In vitro effects on ocular structures (1987)
  • Effects of an erbium:YAG laser on ocular structures (1987)
  • Contact laser: Thermal sclerostomy ab interna (1987)
  • Internal trans-pars plana filtering procedure in humans (1988)
  • Internal pars plana sclerotomy with the contact Nd:YAG laser: An experimental study (1988)
  • Intraocular telescope for age related - Age-related macular degeneration and its management (1988)

Macular degeneration
  • Retinal pigment epithelium transplantation - A technique for retinal pigment epithelium transplantation for age-related macular degeneration secondary to extensive subfoveal scarring (1991)
  • Photodynamic therapy for ARMD - The effect of light-activating .n ethyl etiopurpurin (SnET2) on normal rabbit choriocapillaries (1996)
  • Problems with and pitfalls of photodynamic therapy (2000)
  • Semiconductor photodiode stimulation - Subretinal semiconductor microphotodiode array (1998)
  • of the retina - Subretinal implantation of semiconductor-based photodiodes. Durability of novel implant designs (2002)
  • The artificial silicon retina microchip for the treatment of vision loss from retinitis pigmentosa (2004)

Honors and awards

1973 Fisher Prize, Chicago Ophthalmology Society

1974 Advisor to the Na.onal Commission of Diabetes

1976 Honorary Member, New Zealand Ophthalmology Society

1979 Honor Award, American Academy of Ophthalmology

1981 Honorary Member, All India Ophthalmological Society

1982 Honorary Member, Paraguayan Ophthalmological Society

1984 Honorary Corresponding Member, Peruvian Ophthalmological Society

1988 Honorary Member, Latin American Ocular Angiofluorography and Photocoagulation Society

1989 U.S. Public Health Service grant EY07541 from the National Eye Institute the National Institutes of Health Services, Bethesda, MD

1989 Senior Honor Award, American Academy of Ophthalmology

1990 Honorary member, All India Ophthalmological Laser Society

1996-97 Included in first edition of The Best Doctors in America: Southeast Region

1997 Honor Award, Vitreous Society

1998 Included in fourth edition of The Best Doctors in America

2001 Gertrude Pyron Lecturer Award, Vitreous Society Annual Mee.ng

2001 ASCRS Innovators Award

2003 Life.me Achievement Award, Iranian Ophthalmology Society

2004 Paul Henkind Lecturer, Macula Society

2005 Hall of Fame of Ophthalmology [Reference: http://www.ascrs.org/Awards/Gholam-A-Peyman-MD.cfm]

2005 Pfizer/ARVO Translational Research Award

2008 Waring Medal, Journal of Refractive Surgery

2008 Lifetime Achievement Award, American Academy of Ophthalmology [REFERENCE: http://www.ascrs.org/Awards/Gholam-A-Peyman-MD.cfm]

2010 Iraninan Opthalmology gold medal

External links

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