Inspiring generations: Guy Kezirian’s impact on refractive surgery

I’m your host, Gina Furnival, and over the coming weeks, we will be talking with some of the world’s leading physicians, exploring topics such as innovation and legends, those individuals that have really inspired change in medicine and the people around them.

Today, I’m thrilled to be with my colleague and friend, Kathy Day. Kathy’s our Senior Medical Director at Touch. Hi Kathy, how are you today?

[Kathy Day] Hello, Gina. Well, I’m excited to be here with you today and our fantastic guest, who is going to talk about a pioneer in the field of refractive surgery.

[Gina Furnival] Brilliant. So today’s guest is someone that I’ve had the pleasure of knowing for some time, but I rarely, rarely get the opportunity to actually chat with them outside of our daily roles. So without further ado, please join me in giving a warm welcome to our guest, Dr Jennifer Loh. How are you today, Jennifer?

[Jennifer Loh] I’m well, thank you. Thank you so much for having me. It’s always a pleasure to speak with you.

[Gina Furinval] Well, it’s an absolute pleasure for us too.

For those of you that may not know, Jennifer is a board-certified ophthalmologist based in Miami, Florida. In 2016 Jennifer founded her practice, Loh Ophthalmology Associates, where she is now Medical Director.

In addition to her practice, Jennifer dedicates her time as a clinical and surgical attending for the prestigious Larkin Hospital Ophthalmology Residency Programme. She can also be found travelling the world, frequently speaking at international congresses. In the last few months alone, she has showcased her expertise at Telling It Like It Is congress in Orlando and also Hawaiian Eye, as well as participating in numerous other educational activities and programmes. And last but not least, I will have to mention that you’re also the Editor in Chief of our journal, touchREVIEWS in Ophthalmology.

That is a brief summary of what you’ve achieved. I know you’ve achieved so much more. Is there anything else you’d like to add?

[Jennifer Loh] No. That was such a really nice summary. I really appreciate it, and I I feel very honoured to hear all the kind words, thank you.

[Gina Furnival] It’s a real honour to have you with us as well. So thank you so much for your time.

[Jennifer Loh] No, thank you for having me.

[Kathy Day] So today, Jennifer is going to talk to us about someone who I’m sure many of you will have heard of, Dr Guy Kezirian

Dr Kezirian stands as a visionary in the field of ophthalmology and a pioneer in refractive surgery. From his beginnings at McGill University and Brown Medical School to his groundbreaking work in LASIK technologies, the founding of the Refractive Surgery Alliance Society, and leadership of SurgiVision® Consultants, Dr Kezirian exemplifies dedication to advancing eye care and medical leadership. As the driving force behind the PHYSICIAN CEO™ programme and a supporter of numerous global surgical missions, his career spans healthcare innovation, education and training, establishing him as a pivotal figure in the pursuit of better vision and medical practice standards.

[Gina Furnival] So thanks, Kathy. So without further ado, I think we’ll just jump straight in then. So as Kathy mentioned, Guy is obviously known as a visionary and a pioneer in refractive surgery. Perhaps I could just start by asking you, from your perspective, what is it that you think makes him so revolutionary?

[Jennifer Loh] Well, I mean, your summary was beautiful, and I think that is, you know, such an honour to Guy. He has achieved all of those things you’ve mentioned beautifully, in the biography, as well as more.

To me he’s a visionary because he’s truly changed the mindset of refractive surgery.

You know, he was actually even pivotal in helping create refractive surgery in many ways. He not only had and founded his own refractive surgery practice, and it was actually a refractive only practice, and he says that it was one, if not the first ever, to do that, to be a refractive surgery only type of practice. And, so I think that was extremely admirable. He also worked very closely with Charles Casebeer, MD, in studying LASIK, and he helped write many protocols to help get the approval for the lasers, the Summit laser and the VISX laser in 1996.

You know, and he really, when he tells me his story, when I learn from him every day, he tells me at the time, there was a lot of resistance actually to studying LASIK. You know, we take it for granted that refractive surgery is available to everyone, and just available now as a technology, but there was actually a lot of pushback.

You know, and so he worked, you know, very, very tirelessly. That’s the word I was thinking of. He worked tirelessly, to get this LASIK, FDA-approved and, you know, again, had to go against some controversy. So I think I admire him so much and the fact that he believed in the specialty, believed in the surgery, and was willing to fight for it.

Also, I think that what I admire about him is the fact that he’s changing the mindset, at least in our country and also the world. I mean, he started, as you know, the Refractive Surgery Alliance, and what was really pivotal about starting that is he really brought refractive surgeons together. You know, prior to his initiation of the Refractive Surgery Alliance or RSA, you know the refractive surgeons were quite disjointed, and there wasn’t always necessarily collegiality, so I’ve been told.

It was slightly before my time. But, so I’ve been told. I’ve been fortunate because I was starting my career around the time Guy was starting the RSA and so I’ve always grown up with collegiality amongst refractive surgeons.

However, he tells me that, that was not always the case. And his concept in creating this group was to help further refractive surgery for everyone.

He saw that refractive surgery was becoming sort of a niche surgery for only the wealthy, only people who could afford it. But he realised why can’t we bring it to everyone? Why shouldn’t it be a primary care vision? Like, why can’t this be an option for everyone?

And I think that was really revolutionary to me. Like, why is this held back from other patients around the world? And so that proactive feeling and that, you know, desire to help people around the world, to me, makes him revolutionary.

Not only does he work within refractive surgery, but as you probably already know, he has been on the board for the Himalayan Cataract Project to cure blindness for eight years. And that, as you I’m sure you’ve researched that programme as well, is amazing.

There’s 16 residency programmes involved in the programme where they teach other doctors and countries how to do cataract surgery and to cure blindness. We know that in many of these countries, there’s not enough eye care providers to help the patients. And he’s told me that they do over 100,000 cataracts a year in this programme.

And another programme that he’s worked with, again, to help further the availability of refractive surgery to all types of patients is the Visual Freedom Foundation.

And that is a foundation that’s developed in Nepal and in Peru, where they are bringing the benefits of refractive surgery to patients that otherwise couldn’t afford it.

So I think that, you know, not only is he growing the specialty, he’s bringing the surgery to people who wouldn’t normally have access to it, whether it be cataract surgery or refractive surgery or both. I think this makes him revolutionary. And he’s really taken on the challenges of the world.

[Gina Furnival] I think he’s inspired lots of people to take on surgical missions, hasn’t he as part of their career. It’s always something he is promoting. Have you done one? Have you ever been on a surgical mission yourself?

[Jennifer Loh] I have never, well, I’ve never been on a surgical mission. I did go to India, and visited Dr’s Ashwin and Amar Agarwal in Chennai, India and I was able to observe their surgeries, and they allowed me to participate in some of the surgeries. It wasn’t specifically a mission trip.

So I have not done that. But the one thing that I do in my own community, as part of my Larkin Ophthalmology Residency programme, we do charity surgeries. So I’m teaching the residents, and we find patients. We get them enrolled in programmes, whether it be donated, you know, some of the big surgical companies such as Alcon donate equipment.

I donate my time. The OR donates its time, and we do surgeries for patients that would otherwise not afford them. So while I’m not going to another country, I do feel like it’s amazing how even in our first world country, there’s so many patients that don’t have access to care and have terrible blinding cataracts in my community alone. So that’s been what I’ve tried to do now. It’s nowhere near what Guy Kezirian has done, of course, but this is sort of my humble contribution.

[Kathy Day] He’s clearly, you know, a real entrepreneur. And how much do you think the fact that he’s got an MBA and he kind of builds business frameworks into his models of care, how much do you think that’s really kind of led him down this path of innovation?

[Jennifer Loh] Oh, immensely. And that’s another thing. The business side that he brings and what you said just led me to another thought and another reason why I think that he has been so pivotal to our field, is in addition to helping patients, he also wants to help doctors. You know, he started the PHYSICIAN CEO™ program based upon his idea from his MBA training on how to bring business education to physicians.

He has a real drive to help patients, but also other people in general, including doctors, grow and learn more, and that’s, you know, why I’ve always admired him. He’s a true mentor, and you’re exactly right, he recognizes the fact that in order to do good for the world, we have to have a business foundation in order to affect change. And so I just love his global viewpoint, how he really takes on the challenges of the world. He rises above the mundane.

Also, what’s so impressive about Guy is that he really has a unique ability to see the problems in the world and in our field and identify what needs to be done. And then he also has the courage, the drive, and the work ethic to get it done. And I think that’s something you don’t see in people every day. You know, most of us, including myself, we get caught up in the mundane aspects of life, and it’s hard to sort of rise above. But I think he meets that challenge and exceeds it.

[Kathy Day] Yeah. And I think, you know, there’s obviously the World College of Refractive Surgery and Visual Sciences that he’s been very much involved with, and that’s had a really important role in creating refractive surgery as a single specialty. What’s your understanding of how he’s developed that?

Yes. So that has been obviously endless hard work on his part as well and his colleagues. He started first the RSA in order to have collegiality amongst surgeons, and then the second extension was the World College of Refractive Surgery to educate and create a standardization for refractive surgery because I even noticed that, in my short tenure as a practising ophthalmologist. When I finished training, I had done some LASIK, of course, but there was no real cohesive structure to the education.

Even if one did a fellowship in cornea, most of the fellowships were at academic centres that didn’t necessarily focus on refractive surgery. Right? And it’s such a specialised field that getting regular ophthalmic training in an ophthalmology residency is not necessarily sufficient right now. So having that standardization, opening up the doors to having courses that you could take even after training.

Right? It’s hard for many people to go back and do a fellowship once you’ve been in practice. You have a family. You have a career. You have a mortgage. You know? So it’s hard to do those things, but he’s created an avenue where those interested in refractive surgery can follow a set pathway.

He’s also started an actual fellowship program as well. So in addition to the World College of Refractive Surgery, a person could do a fellowship as well. And again, I think this has created a great standardization for refractive surgery, which only benefits patients in the long run by having skilled surgeons.

[Kathy Day] Exactly. And you know, I think some of the innovation and technologies that he’s been involved with are all very much based around that collaborative approach. Can you tell us a little bit more about the Himalayan Cataract Project, Cureblindness, that he’s been involved with and how his work through philanthropy has really sort of helped individuals regain or retain sight in areas that are often very under-resourced.

Yeah. So I think this project is amazing. You know, it started obviously in Nepal. And, you know, when you, if you’ve, I don’t know if you’ve ever read the book. It’s called Second Suns, if you’ve heard of it. But it’s amazing. I see you nodding your head, so maybe you’ve read it.

[Gina Furnival] I feel I should have done it now. I feel bad.

[Jennifer Loh] Oh, you haven’t read it yet? Definitely get it. And it follows a story, not of Dr Kezirian , but of the two founding members of the Himalayan Cataract Project. And you just see first-hand how impactful it is. I mean, so many of these patients in the book, they travel on foot for days, to get to a centre where they can get their cataracts taken out. And we’re not speaking about 20/30 cataracts. We’re talking about hand-motion cataracts. And the drive of the two founders to create this has been amazing. And then Guy carrying it forward for the past 8 years and not only helping patients in the moment, but training other doctors to carry forward this work, I think, has been incredible. And the work has just been fantastic. 

Amazing.

[Gina Furnival] So I know he touched on his mentoring ability. I know he spends quite a lot of time working with students, doesn’t he? And he’s also written a book called Grades Equal Money, which is, I know, especially designed for high school students and also college freshmen, to improve their academic performance. How do you think he has inspired upcoming ophthalmologists over the years?

[Jennifer Loh] Well, you know, I can tell you my personal experience. The one thing I’ve always appreciated about Guy is his ability to really see a person for who they are, who he or she is.

I remember being pretty recently out of training, feeling like I didn’t know anything, you know, obviously being at a conference and not knowing anyone and feeling quite small. But Guy reached out. Like, he saw me. He started talking to me. He invited me to get involved. He actually invited me to come to the first official Refractive Surgery Alliance meeting, and that should have been in 2013 or 2014 at ASCRS, I believe. He has the original photo of our founding meeting. But just his faith and his ability to care and recognize that I was interested. You know?

Me, again, as a new graduate, meeting him and seeing him as such a high level physician and all that he had accomplished, I was surprised he was even speaking to me. You know? He has that ability to really be, as they say, like, the quote, ‘down-to-earth’ and you know, care about every individual, whether they’re at the top of their field, famous, you know, surgeon, or someone who’s just finished training. And I remember that conversation that we had many, many years ago at a conference, and just the fact that he took interest in me and invited me to become part of a field that I really wasn’t involved in really meant a lot to me, and I know that I’m not the only one that’s had that experience.

He does that with many, many, students and residents and his again, it’s so easy. Once you’re as well known and accomplished as him, it’d be easy to sort of ignore and dismiss the younger surgeons and physicians, but he goes beyond that, and he really, you know, does a wonderful job of being a mentor.

[Gina Furnival] Yeah. I’m sure you’d love to hear those lovely words. And, obviously, he’s made such an impact on lots of people, not obviously, not just you. A real skill in how he connects.

[Jennifer Loh] That’s a great phrase. He’s very good at connecting. Yes.

[Gina Furnival] So thanks so much. That’s a wrap for today’s episode. I want to end by saying a huge thank you to you, our guest, Dr Jennifer Loh. It’s been a real pleasure to have you here and to talk about Guy and all the work he’s achieved so far.

[Jennifer Loh] Yes. Thank you so much for having me. It’s an honour to be the Editor for TouchREVIEWS in Ophthalmology and always an honour to work with you and the team.

[Gina Furnival] Yeah. It’s been a total inspiration. It’s been lovely to learn more about him, actually. But before we go, I want to tell everyone not to forget. If you enjoyed today’s episode, you’ve got to subscribe on your favourite channel and leave us a review. Your feedback is really important to help us improve what we do and also ensure that we bring you more of what you want.

[Kathy Day] Yes. Please do connect with us on social media. Go to LinkedIn and search for Touch Medical Media for updates. And don’t forget to follow our podcast on our Podbean channel. Go to Podbean and search for Visionary Voices, Insights from Healthcare Professionals.

[Gina Furnival] We love hearing from you, and so don’t hesitate to reach out and join the conversation.

So thank you for listening, and until next time, it’s goodbye from me.

[Kathy Day] Goodbye.

[Jennifer Loh] Goodbye.