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Loma Linda University Health CareOphthalmology Department • 11370 Anderson Street, Suite 1800 • Loma Linda, CA 92354

909-558-2154 • Fax 909-558-2180 • LLUeyes.com

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11234 Anderson StreetLoma Linda, California 92350

Nonprofit OrganizationUS Postage

PAIDSan Bernardino, CA

Permit No. 1272

Dr. Narvaez obtained his medical degree and residency training at Loma Linda University School of Medicine. He served as an active duty ophthalmologist in the U.S. Air Force and later completed subspecialty training in cornea, anterior segment, and refractive surgery at the Emory University Eye Center in Atlanta, Georgia.

Dr. Narvaez is currently a professor at Loma Linda University School of Medicine. He has published numerous research articles in refractive and cataract surgery and presented his research at national and international

meetings. Most recently, Dr. Narvaez presented on new surgical techniques at the European Society of Cataract and Refractive Surgeons and is schedule to present at the American Society of Cataract and Refractive Surgery in 2011. He was recently selected by his peers to be included in the Best Doctors in America 2011-2012.

He is also a reviewer for the Journal of Cataract and Refractive Surgery, Journal of Cornea, and Journal of Ophthalmology. His research interests are in cataract surgery, refractive surgery, Intacs for keratoconus, and intraocular lenses. He is an active volunteer in the community and provides eye care in developing nations. Dr. Narvaez is also fluent in Spanish.

Physician Spotlight on Julio Narvaez, MD

Julio Narvaez, MD

A Vision Care Community Outreach Publication

Eye ContactFall 2010/Winter 2011 • Twenty-Ninth Edition

In This IssueIntralase Femtosecond

Laser: A Breakthrough in Corneal Transplantation

and LASIK

•Ophthalmology welcomes

Dr. Samantha Weller

•Our Fellows

•2010 OD Symposium

a Success

•Physician Spotlight

on Julio Narvaez, MD

1

The Department of Ophthalmology at Loma Linda University has been using an innovative ophthalmic device, the Intralase femtosecond laser: the greatest technological advance in corneal transplantation in the last 50 years, and the most significant recent improvement in LASIK surgery. It has also found an important application in the precise implantation of Intacs corneal rings.

A corneal transplant involves replacing a diseased or scarred cornea with new, clear donor tissue. Corneal transplantation restores sight to approximately forty thousand Americans every year, which otherwise would be blind due to corneal disease. In traditional corneal transplants, a circular metal blade is used to create incisions that have straight, vertical edges that require suturing the circumference of the graft to maintain the position of the new cornea. Sutures often stay in the eye for years. Patients generally don’t achieve full visual

recovery for at least one year. After a traditional transplant, the cornea heals weakly, and little pressure is required to rupture the wound.

The IntraLase is the first femtosecond laser in the United States. used to create tongue and groove-like corneal incisions for full thickness corneal transplants. This ultra-precise laser allows the surgeon to create an infinite variety of custom shaped incisions that enable the tissue to fit together much like dovetail joining used in fine carpentry. This provides a more stable graft wound that requires fewer sutures and speeds patient healing and visual recovery considerably, with decreased levels of astigmatism and better vision for patients. Risk for wound rupture is reduced as shaped incisions have demonstrated up to a seven-fold increase in strength.

In refractive surgery, laser-created corneal flaps have many advantages over metal blade (microkeratome) flaps. The laser flaps have

Intralase Femtosecond Laser: A Breakthrough in Corneal Transplantation and LASIKBy Julio Narvaez, MD

11370 Anderson StreetSuite 1800

Loma Linda, CA 92354

909-558-2154909-558-2020 LASIK

LLUeyes.comContinued on page 3

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GrandRounds

If you plan to attend one of the Grand Rounds, please call 909-558-2182 to confirm

the date and location.

First Wednesday of the Month 7:00 - 8:30 am

Faculty Medical Offices11370 Anderson Street, Suite 1800

Loma Linda, CA 92354

Third Wednesday of the Month 7:00 - 8:30 am

Faculty Medical Offices11370 Anderson Street, Suite 1800

Loma Linda, CA 92354

Fourth Wednesday of the Month7:00 - 8:30 am

Fluorescein Angiography ConferenceFaculty Medical Offices

11370 Anderson Street, Suite 1800Loma Linda, CA 92354

Physicians and Optometrists are invited to attend these sessions. Attendees can earn up

to 1.5 hours of Category 1 CME Credits. Attendance is free.

Loma Linda University Health Care Ophthalmology is pleased to welcome Dr. Samantha Weller. She graduated from the Loma Linda University School of Medicine in 2004, followed by an ophthalmology residency at University of South Florida where she also served as chief resident. Dr. Weller also completed a glaucoma fellowship from University of Wisconsin in Madison, WI.

Dr. Weller’s clinical practice and research interests include glaucoma, cataract surgery, and general eye health.

To make an appointment with Dr. Weller, please call Loma Linda University Health Care Ophthalmology at 909-558-2154

We were truly blessed with an outstanding fellowship match this academic year for our senior residents and department.

Our senior residents matched as follows:

Ophthalmology welcomes Dr. Samantha Weller

Our Fellows

Samantha Weller, MD

Our department matched Kristiane Ransbarger, MD for our pediatric ophthalmology fellowship and

Heather Chang, MD from UCLA for our retina fellowship.

Marshall Ford, MDUniversity of Rochester

Cornea

Ben Kronberg, MDMass Eye and Ear

Glaucoma

Lynelle Smith, MDPrivate Practice

(Dr. Joanne Cochrane) in Northern California

Neuro/Oculoplastics

Kristiane Ransbarger, MDLoma Linda UniversityPediatric Ophthalmology

3

Specialties & StaffCataract Surgery

Howard V. Gimbel, MD, MPH, FRCSC, Chair

Michael Rauser, MD, Residency Program Director,

Vice Chair for Clinical Affairs

Wayne Isaeff, MD

Kelly Keefe, MD

Julio Narváez, MD

Richard Tamesis, MD

Donald G. Tohm, MD

Samantha Weller, MD

Cornea & External DiseaseJohn Affeldt, MD, MPH

Julio Narváez, MD

Mark Sherman, MD

Dobli Srinivasan, MD

GlaucomaRichard Tamesis, MD

Samantha Weller, MD

Shyun Jeng, MD

Medical OphthalmologyErnest Zane, MD, Vice Chair for Academic Affairs

Harvey Lashier, MD

Patrick McCaffery, MD

Neuro-Ophthalmology & Adult StrabismusMadhu R. Agarwal, MD

Ocular PathologyKelly Keefe, MD

Oculoplastics & Orbital SurgeryMadhu R. Agarwal, MD

Kelly Keefe, MD

OptometryWilliam Kiernan, OD

Rosalynn Nguyen, OD

Pediatric OphthalmologyJennifer Dunbar, MD

Leila Khazaeni, MD

Refractive SurgeryHoward V. Gimbel, MD, MPH, FRCSC

Julio Narváez, MD

UveitisMark Sherman, MD

Richard Tamesis, MD

Vitreoretinal Diseases & SurgeryJoseph Fan, MD

Michael Rauser, MD

Mukesh B. Suthar, MD

Riverside County Regional Medical CenterLarry Bowes, MD, Vice Chair

Wayne Isaeff, MD

Patrick McCaffery, MD

Gerald Schultz, MD

Laura Teasley, MD

greater precision of thickness, within 10 to 15 micrometers, allowing the safe creation of thinner flaps with less dry eye symptoms, stronger biomechanical properties, and better visual outcomes after LASIK. In addition, the location, size, depth, and edge configuration of the flap can be customized by the surgeon for the individual patient. The vertical configuration of the edge of the flap nearly eliminates the risk of flap dislocation or microscopic folds, which require repositioning of the flap.

While Intacs placement for keratoconus with a mechanical metal dissector works well, some problems have been associated with it. Problems can arise when setting the depth for placement of the Intacs with anterior or posterior perforations. Epithelial defects can occur which can be painful. Placing Intacs with femtosecond laser created channels is a more precise and safe approach. Patients like the fact that the laser is faster and applies less pressure on the eye, providing a safer, more comfortable procedure with excellent results.

In summary, the use of the IntraLase femtosecond laser for corneal transplantation, LASIK surgery, and Intacs placement is a technological breakthrough that improves outcomes in both refractive and therapeutic corneal surgery.

Intralase Femtosecond Laser: A Breakthrough in Corneal Transplantation and LASIK continued from page 1

Loma Linda University Health Care Ophthalmology hosted the 7th Annual Optometry Symposium on Sunday, November 7th at the Wong Kerlee International Conference Center in Loma Linda, CA. Approximately 170 Optometrists from Los Angeles, Orange, San Bernardino, and Riverside Counties attended. A total of 6.0 continuing education credits were certified by the California Board of Optometry. A wide range of topics were discussed, including current use of Anti-VEGF drugs in the treatment of retinal and choroidal disorders, contact lens related keratitis, low tension glaucoma, update on IMT and multifocal IOLs, and acute ocular injuries.

If you or a colleague are interested in attending next year’s symposium, please contact Patti Mena at 909-558-2000 or pmena@llu.edu to be put on the contact list.

2010 OD Symposium a Success