You specialize in cataract, refractive, corneal, and glaucoma surgery. What surgical cases do you find most enjoyable to perform and rewarding once successfully completed?

My favorite procedure is ReLACS (refractive laser-assisted cataract surgery) with the LenSx femtosecond laser [Alcon Laboratories, Inc.]) plus implantation of an iStent (Glaukos Corporation). With this elegant, combined procedure, we can often eliminate glasses and glaucoma medications in one short, painless surgery. The refractive outcomes after microinvasive glaucoma surgery are similar to those after cataract surgery alone. The outcomes with both of these technologies have been tremendous, making it my patients' favorite procedure; hence, it is my favorite, too.

It is relatively easy to make patients happy, but it is hard to make them so happy that they cannot stop talking about their experience. Vance Thompson, MD, my senior partner, has been combining the best available technology with the best experience for patients for decades, and I continue to learn from his approach.

How has your cornea and glaucoma fellowship at Minnesota Eye Consultants influenced the way you practice medicine?

My fellowship at Minnesota Eye Consultants was the single most formative year in my career. There is no greater learning experience than an apprenticeship, and I was fortunate to learn from some of the best surgeons and humans on the planet. I have had tremendous mentors at all stages of my education, and my fellowship year was a mountaintop experience—the culmination of all my prior educational activities. I learned to combine humility with technology and made a commitment to become a better surgeon and doctor every day. Becoming a skilled surgeon in glaucoma made me a more confident corneal surgeon and vice versa. As a result of training in both glaucoma and cornea, I take a more holistic approach to caring for people.

I also learned that progress in ophthalmology occurs best when there is a win-win-win between patients, doctors, and industry. As doctors, we are responsible for providing the best available treatment to our patients, and we must also innovate in ways that are ethical so that future generations of patients will have even better options than those we can offer today.

How have recent studies influenced your surgical technique or the technology that you use?

Currently, data related to microinvasive glaucoma surgery, primarily the pivotal trials of the iStent, and the Tube Versus Trabeculectomy (TVT) Study influence my surgical technique. The TVT Study demonstrated the unpredictability and safety concerns of traditional glaucoma surgeries such as trabeculectomy and tube shunts. Because of this study, tube shunts play a more prominent role than trabeculectomy in my treatment of advanced glaucoma. The studies of cataract surgery and the iStent have convinced me that cataract surgery alone is probably the safest glaucoma surgery available and that, when it is combined with the iStent, it is a safe and even more effective glaucoma surgery.

You have received many prestigious awards during your career. Is there one of which you are most proud?

This question made me laugh. I have been fortunate to receive several awards, but I am not convinced they were entirely deserved. Many folks are doing tremendous work, and these awards likely represent my being in the right place at the right time. If I had to say which professional awards make me most proud, it would be those related to my work with cerebrospinal fluid pressure and glaucoma. Many people at Duke University— Terry Kim, MD, and R. Rand Allingham, MD, in particular— encouraged me to develop the science behind the theory. I feel extremely privileged to pursue the idea that glaucoma is a two-pressure disease, where the difference between IOP and cerebrospinal fluid pressure may drive the pathophysiology behind glaucomatous damage. If proven to be true, this may redefine how we think of glaucoma.

What do you consider to be your greatest personal achievement outside of your profession?

I strive to be a good father and husband. It is always a challenge to balance a beloved profession with a beloved family. I am still learning the ropes regarding placing the proper emphasis on these passions.