Gholam A. Peyman

Gholam A. Peyman is an ophthalmologist, retina surgeon, and inventor. He is best known for his invention of LASIK eye surgery,^[2] 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).

Life and career

Peyman was born in Shiraz, Iran. At the age of 19, he moved to Germany to begin his medical studies. He received his MD at the University of Freiburg in 1962. He completed his internship at St. Johannes Hospital in Diusberg, Germany in 1964 and at Passaic General Hospital in Passaic, New Jersey 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, 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 Illinois Eye and Ear Infirmary, University of Illinois at Chicago 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 College of 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 College of Medicine - Phoenix & Optical engineering at the University of Arizona in Tucson. Peyman was awarded in 2013 an honoree doctorate degree from the National University of Cordoba in Argentina.^[3]

The Invention of LASIK surgery and its improvements

At the Illinois Eye and Ear Infirmary, Peyman, because of his interest in the effects of lasers on tissues in the eye, 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 patterns. 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.^[4]

In late 1982, he read an article from IBM 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. 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.^[5]

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.^[6]

However, this procedure has had its own limitations. For example, the implant has been limited to a size of 2 mm diameter and there is also a possibility that a cornea rejects the implant. In 2015 Peyman invented a new refractive surgical procedure that eliminates most of the shortcoming of refractive surgery and implants rejection. His new procedure is now called “Mesik” (Meso, Inside, Implant, Keratomileusis), in which at first a corneal pocket is created with a femtosecond laser, and then the wall of the pocket is crosslinked using riboflavin solution and UV radiation creating a transparent cell-free crosslinked collagen barrier surrounding the implant. This creates an immune privileged cell free space that does not initiate an immune response to an implant. A synthetic organic or polymeric lens can be implanted in the corneal pocket to compensate for the patient’s refractive error. The implant can be exchanged as the eye grows or refractive need dictates.^[7]

Laser in ophthalmology

Peyman has been granted 174 US Patents^[8] covering a broad range of novel medical devices, intra-ocular drug delivery, surgical techniques, as well as new methods of diagnosis and treatment.

• First attempt to correct refractive - Modification of rabbit corneal curvature with use of carbon dioxide laser burns (1980)^[9]
• Errors using lasers Evaluations of laser use in ophthalmology - Histopathological studies on transscleral argon-krypton laser coagulation with an exolaser probe (1984)^[10]
• Comparison of the effects of argon fluoride (ArF) and krypton fluoride (KrF) excimer lasers on ocular structures (1985)^[11]
• The Nd:YAG laser 1.3µ wavelength: In vitro effects on ocular structures (1987)^[12]
• Effects of an erbium:YAG laser on ocular structures (1987)^[13]
• Contact laser: Thermal sclerostomy ab interna (1987)^[14]
• Internal trans-pars plana filtering procedure in humans (1988)^[15]
• Internal pars plana sclerotomy with the contact Nd:YAG laser: An experimental study (1988)^[16]
• Intraocular telescope for age related - Age-related macular degeneration and its management (1988)

Remote controlled system for Laser Surgery:

• (2013)8,452,372 System for laser coagulation of the retina from a remote location.

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)
• 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)
• Testing intravitreal toxicity of Bevacizumab (Avastin), (2006)
• Oscillatory photodynamic therapy for choroidal neovascularization and central serous retinopathy; a pilot study (2013).^[17]
• 8,141,557 Method of oscillatory thermotherapy of biological tissue.

Artificial Retina Stimulation

• Semiconductor photodiode stimulation of the retina - Subretinal semiconductor microphotodiode array (1998)
• 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)

Quantum dots and Optogenetic for artificial retinal and brain stimulation and gene therapy

• 8,409,263—Methods to regulate polarization of excitable cells
• 8,388,668—Methods to regulate polarization of excitable cells
• 8,460,351—Methods to regulate polarization and enhance function of excitable cells
• 8,562,660—Methods to regulate polarization and enhance function of excitable cells

Adaptic optic phoropter for automated vision correction

• 7,993,399—External lens adapted to change refractive properties
• 8,409,278—External lens with flexible membranes for automatic correction of the refractive errors of a person
• 8,603,164—Adjustable fluidic telescope combined with an intraocular lens

Honors and awards

Among other awards and honors, Peyman has received the National Medal of Technology and Innovation (2012),^[18] the Waring Medal of the Journal of Refractive Surgery (2008),^[19] and the American Academy of Ophthalmology's Lifetime Achievement Award (2008)^[20] He was named a fellow of the National Academy of Inventors in 2013.^[21]

References

• Dr. Peyman's CV (Source: Tulane University)

External links

• 20 YEARS of LASIK
• Soheilian, Masoud (2011). "A Tribute to Dr Gholam A Peyman". Journal of Ophthalmic and Vision Research. 6 (1): 1&ndash, 2. Archived from the original on 22 March 2012.
• Artificial Silicon Retina
• Tulane Ophthalmology Faculty
• Dr. Gholam Peyman Official Website