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One To Watch | Mar/Apr '20

One to Watch: Joshua Frenkel, MD, MPH

Dr. Frenkel is an anterior segment surgeon at Wang Vision Institute in Nashville, Tennessee, focusing primarily on cataract and refractive surgeries, corneal surface and crosslinking procedures, and MIGS.

Please share with us your background.

I grew up in Madison, Wisconsin. My parents are both in the literary field—my mother is an author and my father is an editor, so I’m somewhat the black sheep of the family as the only one who went into science. I attended Oberlin College in Ohio, where I was a 4-year letterman in baseball. I then moved to New Orleans, where I attended Tulane University for medical school and residency. It was in New Orleans that I met my wife, Carolyn, during my year off prior to medical school. I was actually a lowly backwaiter on Bourbon Street at the time, without a dollar to my name! We have now been together for almost 11 years and married for 7 years. After my residency at Tulane, I completed an advanced anterior segment fellowship at Vold Vision with Steven Vold, MD; Laura Voicu, MD; and George Tanaka, MD. The fellowship focused on glaucoma with a heavy emphasis on MIGS, as well as cornea, cataract, refractive surgery, and dry eye. I finished fellowship in July 2019 and joined Ming Wang, MD, PhD, at Wang Vision Institute (WVI) in Nashville.

What drew you to ophthalmology and, specifically, to your field of interest?

I became interested in ophthalmology as a third-year medical student at Tulane. As luck would have it, I met a then-intern named Dr. Blake Williamson, who came from a family of ophthalmologists and was going into the field himself. Blake impressed upon me how incredible the field is and recommended that I complete a rotation in ophthalmology. Once I rotated, I was hooked. Seeing the incredible impact one could have by saving a patient’s sight resonated with me. I was also drawn to cataract surgery—the ability to transform someone’s world in a relatively short time amazed me. Watching the surgery, I felt like it was what I was meant to do.

Please describe your current position.

I am currently an anterior segment surgeon at WVI, where I specialize in cataract and refractive surgery, glaucoma, cornea, and ocular surface disease.

Who are your mentors?

Many people have played an important role in my young career. Jonathan Solomon, MD, was instrumental in guiding me onto my current path. I am grateful to him for taking a chance on me as a second-year resident and helping me get involved in refractive research, which helped to propel my career and start my participation in meetings.

Ramesh Ayyala, MD, the former program director at Tulane and now chairman at University of South Florida, was a mentor to me during medical school and a big reason I chose to stay at Tulane for residency. My fellowship mentors, Drs. Vold and Voicu, helped shape me into the surgeon and clinician I am today. They groomed me to step into any type of practice that I wanted, with their breadth of clinical and surgical knowledge. I have to add that Dr. Wang has been a great mentor to me during my brief time at WVI.

Many other individuals, including Greg Parkhurst, MD, FACS; Gary Wörtz, MD; Damien Goldberg, MD; Bill Trattler, MD; and Dr. Tanaka, have been incredibly helpful along this journey.

What has been the most memorable experience of your career thus far?

One of the most influential experiences for me thus far was being a part of a corneal transplant project in Mongolia with Dr. Voicu. In 2018, we went on a medical mission and performed about a week’s worth of corneal transplants, glaucoma surgeries, and cataract surgeries on patients from all over Mongolia. It was humbling to see how much the local practitioners do with so little, in terms of resources and technology. I gained a renewed appreciation for the luxuries we have in the United States, especially when it comes to surgical instrumentation and devices, which I believe we largely take for granted. I also had the privilege of giving a talk on advances in MIGS to the Mongolian Eye Congress, which was celebrating its 90th year. It was extremely humbling to be able to speak at the national meeting.

Since finishing fellowship, probably the neatest experience for me was being a part of the PanOptix Trifocal IOL (Alcon) launch in September 2019. I was among the first in the nation to implant the lens and the first in Tennessee to do so with laser-assisted lens surgery. As a surgeon recently out of fellowship, I was honored to participate in such a major advancement in lens technology.

What are some new technological advances that you have found particularly exciting? Which advances in the pipeline are you most enthusiastic or curious about?

As noted above, the PanOptix IOL has been hugely exciting for me. To have an option for patients that offers good vision for distance, intermediate, and near is a game changer. I am also intrigued by the Light Adjustable Lens (RxSight) as a technology with tremendous potential and variety of use.

Additionally, I am excited about more MIGS devices coming down the pipeline, including Preserflo (Santen), which may be a great option for patients with more severe glaucoma. I’ve been learning more about artificial iris prostheses, which are a great option for patients with a history of trauma.

What is the focus of some of your research?

While in fellowship at Vold Vision, I was able to be on the ground floor of a lot of research projects with a focus on MIGS. Seeing firsthand how clinical trials are run was valuable and something I hope to continue at WVI. I am also interested in advances in IOL technology and hope to continue to be an active participant in IOL research and clinical trials.

What is a typical day in your life? What keeps you busy, fulfilled, and passionate?

A typical day in my life isn’t very typical. We have a fun, unique flow to our clinic at WVI. On clinic days, the two surgeons bounce back and forth between seeing patients and performing surgery. Clinic days involve the business side of things as well, which can include meetings with optometrists, education for our technicians, or discussions on our future plans. OR days are, of course, more straightforward in that I am solely performing intraocular surgery. I personally enjoy the diversity in my day-to-day activities, as things never get mundane.

What advice can you offer to individuals who are just now choosing their career paths after finishing residency or fellowship?

Follow your heart, but use your head. Research the practices or fellowship programs that interest you. If you pursue a fellowship, think about your surgical volume, potential mentors, and how the experience will prepare you for practice. When looking at jobs, take a holistic approach and don’t just get wowed by the biggest paycheck; consider your fit with the practice, staff, administration, location, and work-life balance. Around 70% of ophthalmologists leave their first job within 2 years. Don’t become a statistic!

Tell us about an innovative procedure you are performing or a new imaging/diagnostic tool that has improved your practice.

At WVI, I’m fortunate to have access to many cutting-edge technologies. As for new techniques or tools, I’ve been implanting a number of PanOptix Trifocal IOLs, which have been tremendous for us so far. I’ve also been performing SMILE with great results. I performed the procedure on one of our employees a few weeks ago, and she has been thrilled. I am looking into performing artificial iris implantation as well.

Neda Shamie, MD | Section Editor