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One To Watch | Mar/Apr '22

One To Watch: M. Amir Moarefi, MD

Dr. Moarefi is a cataract and refractive surgeon at LA Sight in Los Angeles.

1. Please share with us your background.

I was born in sunny Los Angeles, where I was raised by my newly immigrated Iranian parents and my older sister. I was the first person in my family to be born in the United States. Civil unrest and revolutionary changes had forced my parents to leave their homeland and seek better opportunities for themselves and their children. My parents studied, worked, and raised a family, all while trying to learn English. My father worked multiple jobs, and my mother worked full time while taking care of my sister and me. My parents’ discipline and hard work allowed them to overcome challenges and achieve success, setting an example for me as I worked toward achieving my dreams.

Growing up, I always enjoyed being outdoors and playing sports. I played basketball and tennis, and I played tuba in the concert band at Santa Monica High School—although during those days the tuba was larger than me, I still managed. My parents often reminded me to be grateful for everything we had. They encouraged me to volunteer at the local library and YMCA as much as I could. My mother was always a voice of reason in my ear. She would celebrate my achievements and successes and would show me the lessons in my failures, of which there were many.

After high school, I attended the University of California, Los Angeles, and received a bachelor’s degree in history. I was unsure of what I wanted to do with my life, but I was always drawn to medicine because it offered the opportunity to help and support people. I struggled in college and had to apply to medical school a few times before being accepted. When I finally held that medical school acceptance letter in front of my eyes, I realized that the fate of my future was in my hands, and the discipline my parents had exemplified was reinvigorated.

I left Los Angeles for the first time to attend medical school in Chicago. It was the most challenging and rewarding experience. Knowing that not everyone who wants to travel this road gets the opportunity, I was so grateful to finally be in medical school, and I enjoyed the challenges that came with it. I studied, did research, and taught others until I achieved my dream of becoming an ophthalmologist. Prior to beginning my residency, I took 1 year off to travel across South America to volunteer at various medical clinics and learn Spanish, as I knew that a large percentage of my patient base in Southern California would be Hispanic.

After my sabbatical year, I began my ophthalmology training at Case Western University/University Hospitals in Cleveland. Prior to returning to Los Angeles to begin my practice, I completed a fellowship at Cleveland Eye Clinic, where I learned from two of the best anterior segment surgeons in the country, William F. Wiley, MD, and Shamik Bafna, MD.

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

I was not familiar with ophthalmology when I entered medical school. Growing up, I had an amazing family doctor who always made me feel comfortable, heard, and supported. This approach inspired me to follow a similar path, where I would be able to provide my patients with a high level of care.

When I started my clinical rotations in medical school, I knew that I wanted to pursue surgery in order to develop a skillset I could craft and perfect. I originally liked the field of orthopedics, especially hand surgery, and was intrigued by the microsurgical aspect of orthopedic care. I learned about ophthalmology because of a 2-week rotation during my surgery block, and I was instantly impressed by the precise nature of the procedures. On my first day, I observed a mature cataract surgery; when the patient’s bandage was removed postoperatively, I watched someone who had been blind for 5 years regain vision. The patient began to cry, as it was the first time she was able to see her grandson. That was my first experience in medicine that gave me chills, and I became hooked on the idea of dedicating myself to curing, treating, and preventing blindness. When I started conducting research on ocular immunity, I grew even more impressed by the field.

I love ophthalmology more every day. Our diagnostic and treatment equipment is advancing rapidly to enable more accurate evaluation and management of ophthalmic conditions. I love the clinical-surgical balance of the space, the fast-paced nature of ophthalmic surgery, and the eye’s ability to indicate when something is wrong. The eye truly is the window to the body, and, by examining it closely, ophthalmologists can be the first to diagnose systemic conditions. I enjoy the bond I form with my patients when I help them see in a way they previously never could. Mostly, I love how ophthalmology helps to fulfill a large unmet need internationally and that I can help the cause while fulfilling my passion for travel.

3. Please describe your current position.

I am currently in my third year of practice, specializing in cataract and refractive LASIK surgery with a subspecialty in cosmetic eyelid surgery. I am back in my hometown of Los Angeles working in a high-end LASIK and cataract refractive practice. My brand focuses on enhancing patients’ lives by performing high-quality vision and aesthetic surgery.

4. Who are your mentors?

The first and most important mentor in my life is my mother. She taught me to remain humble and grateful, and she instilled in me a sense of ethics, discipline, and love. She made me believe that I can achieve anything and has been my biggest supporter since day 1. In residency, two of my attendings really helped elevate me as a physician. William Reinhart, MD, shared with me his wealth of knowledge and experience and taught me that preparation is key. Anne Jacobs, MD, allowed me, as a young surgeon, to feel safe expanding my skills. She believed in me from our very first surgery together, and she exudes a type of love and happiness in the OR that allows any resident to feel comfortable enough to shine.

I have made it to where I am in my career today thanks to my fellowship mentors Drs. Wiley and Bafna. My residency program did not have a fellowship program available; however, I heard about these two amazing surgeons in the neighborhood, and I took every chance I had as a resident to shadow them. They practiced ophthalmology like I envisioned myself doing, and they were so open to sharing their wisdom with me that I eventually asked them if they were willing to start a fellowship at Cleveland Eye Clinic so that I could have an additional year with them. Luckily for me, they accepted, and today their program is considered to be the top anterior segment and refractive surgery fellowship available.

Drs. Wiley and Bafna instilled in me the patience to approach each case in a relaxed manner, and they taught me how to cultivate my talents and remain dedicated to self-improvement. They are the ones who took my training to the next level. Extremely dedicated to perfection and precision, Drs. Wiley and Bafna gave me the confidence to perform high-level and high-volume surgery with zest and accuracy. I wrote about my appreciation for them in a previous edition of Cataract & Refractive Surgery Today.

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

The journey itself has been extremely rewarding. I’ve enjoyed every single day along the way, as each surgery continues to teach and humble me. I recognize what a privilege it is to be able to improve patients’ vision and care for their all-important sense of sight. Some of my favorite experiences are those that provided the opportunity to pass along my knowledge, including my volunteer medical trips to Jordan to aid Syrian refugees and to India. I feel blessed to be in a position where I can give without expecting anything in return. The global lack of access to health care desperately needs attention, especially in ophthalmology, and it is something that I will dedicate time to every year for the remainder of my career.

Being accepted to my fellowship at Cleveland Eye Clinic was an extremely proud moment. In 1 year, I was able to gain 10 years’ worth of surgical volume experience while also getting firsthand exposure to industry and all the latest and greatest technologies. I have also been an author of two textbooks, have published multiple journal articles, and have had the honor of writing many opinion pieces for my colleagues in ophthalmology. Each year gets more fun!

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

I am very excited about the advances in lens-based surgery, including the first trifocal IOL approved in the United States, the AcrySof PanOptix (Alcon). Other developments in the pipeline continue to show promise for our specialty. The Light Adjustable Lens (RxSight) is an example of how dedication to excellence can allow patients to achieve incredible vision. I always look forward to new technology for the treatment of presbyopia, whether topical or surgical. Following the Zoom era of the COVID-19 pandemic, refractive surgery numbers have skyrocketed. More and more people want to be less dependent on spectacle correction, especially when their lenses get fogged up while wearing masks!

Advances in the treatment of glaucoma, MIGS specifically, also continue to impress me. Patients are now able to achieve IOP control without undergoing invasive surgery.

7. What is the focus of some of your research?

I am not currently involved in any research, but most of the research I have done has been in the refractive space and has focused on various methods and techniques for improving quality and functionality of vision for patients of all ages.

I am currently focusing my efforts on mentorship and volunteerism, as these initiatives align more closely with my passions.

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

Every morning before work, I go for a nice run along the beach, followed by a cold shower. This practice energizes and relaxes me before I head into clinic. I take my health very seriously. This includes my physical, mental, and spiritual health. We dedicate a large part of our day to fielding patients’ issues and complaints, so it is extremely important to nurture our own needs. Exercise boosts my energy and helps my mental clarity. During my morning run, I am able to organize my day in my head, which allows me to be more efficient. In the evenings, since I do not own a TV, I enjoy reading, yoga, meditation, and cooking. Eating healthy is also important to me. The better the quality of food I eat, the better I feel. Read more on how I spend my day here).

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

Be honest with yourself about where you want to focus. Don’t settle until you create the practice you always envisioned, whether it is a solo practice that you build from the ground up or a group practice in which everyone takes a community approach toward caring for a large population. Find what makes you most comfortable and put yourself in that position. Do not worry if you are not yet in that situation or have a hard time finding it. It is common to have a first job that tests you—this will help to illuminate your priorities and non-negotiables. Your first job may not be what you wanted it to be, and that is OK. I have lived through it, and it made me stronger.

Try to always use your time to expand your skillset however possible. Stay in touch with your mentors and keep your options open. Everyone feels a bit rushed when looking for their first job out of training, but it is important to take the time to explore the different options. Every opportunity can provide a new connection in the short or long term, whether it is an email, phone call, or an interview. Showing up and being present will always play out in your favor. You miss 100% of the shots you don’t take. Visiting different practices will help you see how different clinics function and operate. Reach out to doctors in the locations that interest you and see if they will invite you in. This is a great way to build relationships with them, whether you end up working together or not.

Then, find a reputable medical lawyer to read over your first employment contract and ensure that there are no limiting or restricting clauses that will hinder your future. Lastly, stay positive; you are an ophthalmologist! This is such a special field of medicine. There will always be a need for us, and as long as we remain focused on providing the best patient and surgical care possible, we will do well.

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

Advances in IOL technology have enhanced both my outcomes and my relationships with my patients. A larger toolkit for treating patients who were previously not good candidates for advanced technology lenses ultimately allows more patients to achieve high-quality vision.

By dedicating myself to ocular health and aesthetics, I have been able to foster great relationships with my postoperative cataract patients and continue to treat them under the aesthetic spectrum, which gives me another way to connect with them and provide them with long-term care.