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One To Watch | Sept/Oct '20

One to Watch:
Neda Nikpoor, MD

Dr. Nikpoor is a cataract, refractive, and cornea specialist at Aloha Laser Vision in Honolulu, Hawaii.

Please share with us your background.

I grew up in Oklahoma as a first-generation American born to Iranian immigrant parents. My mother and father showed me boundless, unconditional love and made sure that volunteerism and community service were important parts of my upbringing.

I attended college and medical school at the University of Oklahoma, and I then had the immense privilege of completing residency and a cornea fellowship at the Bascom Palmer Eye Institute in Miami, Florida. Following my cornea fellowship, I had the opportunity to serve as the Himalayan Cataract Project (HCP) global ophthalmology fellow at Stanford University in Stanford, California. After training, I first practiced in Orange County, California, and I now live and practice in Honolulu, Hawaii.

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

I knew early in college that I wanted to be a doctor with a focus on philanthropy. It was through a serendipitous sequence of events at age 19 that I heard of Geoff Tabin, MD, and the HCP, and that brought everything together for me.

During college, I volunteered weekly at a free clinic. There, I fell in love with medicine and aspired to someday open my own free clinic. As luck would have it, I landed a research position the summer after my freshman year of college in a lab at the Dean McGee Eye Institute in Oklahoma City, Oklahoma. A chance meeting with Mike Siatkowski, MD, in the parking lot led to me observing my first eye surgery. I was instantly drawn to ophthalmology’s elegant surgeries and the fast recovery of vision. That summer, I read Mountains Beyond Mountains by Paul Farmer and began developing a strong interest in global medicine. My mentors Dr. Siatkowski and Brad Farris, MD, helped me connect the dots by telling me about Dr. Tabin and the HCP.

Cataract surgery in particular provides a unique opportunity to restore sight and quality of life, with a return on investment and impact that is comparable to immunizations. The more I read about the HCP, the more certain I became that I had found my calling in ophthalmology and, specifically, in becoming a cataract and cornea specialist.

Please describe your current position.

I am a cataract, refractive, and cornea specialist at Aloha Laser Vision in Honolulu, Hawaii.

Who are your mentors?

I have been incredibly fortunate to stand on the shoulders of giants every step of the way, and it would be impossible to name every one of them here.

At Bascom Palmer, every faculty member I learned from was as approachable as they were nationally renowned. Carol Karp, MD, and Guillermo Amescua, MD, taught me what it meant to tirelessly devote time to the most challenging patients. Sonia Yoo, MD; Kendall Donaldson, MD, MS; and William Culbertson, MD, taught me how to think like a refractive surgeon. Eduardo Alfonso, MD, took the time to open the door for me to meet and ultimately work with Dr. Tabin.

During my global fellowship, I learned so much about ophthalmology, global blindness, and life (not to mention rock climbing!) from Dr. Tabin. He is one of the most remarkable, unique people I have had the privilege to know. His enthusiasm for life and his commitment to ending global blindness are unstoppable. Through Dr. Tabin, I have been able to meet some of the world’s greatest thought leaders in ophthalmology, including Sayan Basu, MD, and Virender Sangwan, MD. Matt Oliva, MD, is the best example of someone whose career I try to emulate. He has a thriving anterior segment practice in the United States and has devoted his career to advancing eye care in Ethiopia. Dr. Oliva has shown me that private practice affords the flexibility to work globally in a meaningful way.

At my first job, I learned the art of refractive surgery and comanagement from Tom Tooma, MD. Practicing in Southern California led me to a few early opportunities to work with industry and speak at meetings, and George O. Waring IV, MD, FACS, and Gary Wörtz, MD, (along with Drs. Donaldson and Yoo) have become some of my early mentors in that world.

After leaving California, I was fortunate to find myself in practice in Hawaii with Alan Faulkner, MD, who has been an incredible mentor. Not only is he a great surgeon and clinician, but he has developed a practice where patients are treated like family and, with the help of the most advanced technology, are able to achieve great outcomes. Dr. Faulkner thinks differently about both business and refractive surgery, which is partly a result of his completing the Physician CEO program at the Kellogg School of Management at Northwestern University. Because of his experience, along with the guidance of another one of my mentors, Guy Kezirian, MD, MBA, I am in this year’s Physician CEO class. Drs. Faulkner and Kezirian have helped me to sharpen my critical thinking skills as they continue to share their clinical and business acumen.

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

Without a doubt, the most memorable experience of my life occurred in my third year of residency, when I spent 2 weeks in Ethiopia working with Dr. Oliva on the HCP. During a cataract outreach program, the team was able to restore sight to more than 1,000 individuals who were blind from cataracts. Each morning, we unpatched about 200 cheering, jubilant Ethiopian patients. They had the most incredible reactions I have ever seen. There is this indescribable moment when you watch a blind person see for the first time in years, and the joy that moment brings is unlike anything else. After celebrating and dancing with patients in the morning, we would continue working to restore sight to another 200 eager patients.

That experience in Ethiopia solidified my desire to devote my career to eliminating global blindness. Although my path had a few twists and turns along the way, my ultimate goal has remained the same. What drives me is the desire to help people see the world clearly, whether by delivering state-of-the-art eye care in the United States or by helping to eradicate avoidable blindness in Ethiopia and other places throughout the developing world.

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

Our practice is part of the EVO Visian ICL (STAAR Surgical) FDA study, and I look forward to seeing the results and approval of that lens. In my opinion, the EVO will make ICL surgery even safer and easier by eliminating the need for peripheral iridotomy. In the cornea space, I look forward to Donald Tan, MD, and others revolutionizing corneal endothelial transplant surgery with injectable endothelial cells. Dr. Basu, of the LV Prasad Eye Institute in India, has achieved incredible early results using mesenchymal stem cells to erase corneal scars. The trend toward safer, more targeted therapies is exciting and has the potential to revolutionize cornea surgery and render some of our current procedures obsolete.

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

On a typical weekday, I like to wake up earlier than necessary to enjoy the calm that is unique to the morning. I prefer to start every day with a combination of yoga, meditation, and time for quiet reflection.

After a pleasant bike ride to the office, I am lucky to join the most loving work family—they go above and beyond to take amazing care of our patients. No matter how hectic our schedule, there is so much laughter and warmth in the office. My senior partner, Dr. Faulkner, inspires me with his vision and mentorship. I am thankful that I look forward to going to work every day.

Outside of work, my wonderful husband and I stay very active. We love rock climbing, surfing, sailing, hiking, camping, and most outdoor activities. My husband is my biggest supporter, and he actively encourages me to chase my dreams, even when they seem unorthodox or unattainable.

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

Figure out what is important to you, and envision your ideal job, rather than just choosing from the available options. It is easy to fall back on the pro-con lists and to compare job A to job B. In my opinion, a better way to approach the process is to imagine your ideal day/week/month/year/career. Find your why, and build the how and what around that. Choose or create a path that is compatible with your goals.

It is sometimes hard to know what you want early on. In fact, you may not realize until after you embark on one path that it is not going to lead you where you want to go. Changing course takes courage, and those who have done so know that it is not to be considered a failure. Every detour is a part of your journey and ultimately gets you closer to your dream. Make the effort to be happy along the way. It’s all part of your story and time well spent.

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

One of the main factors that drew me to my practice was the advanced technology it offers. Interestingly, Dr. Faulkner’s father, Gerald Faulkner, MD, was an ophthalmologist who learned from Charles Kelman, MD, and was the first to perform phacoemulsification in Hawaii. Dr. Faulkner has continued this legacy of being an early adopter and is often the first to bring new technology to Hawaii.

The Light Adjustable Lens (RxSight) has been one of those firsts and has been a game-changing technology for our practice. It is truly a disruptive innovation in that it has changed how I approach refractive cataract surgery. When I first heard about the device, I thought it would be great for post–refractive surgery patients or other challenging IOL calculations, but I had no idea how often I would recommend it to patients. The range of vision that patients can achieve with this technology is unlike any I have seen with other monofocal lenses, and many patients achieve spectacle independence with blended vision. Consistently and accurately hitting the refractive target is finally possible. Most importantly, patients love it. Similarly, we were chosen as one of a handful of practices in the country to have early access to the Vivity lens by Alcon. Our early results with both lenses have been very promising! It’s truly an exciting time to be a refractive cataract surgeon.

Neda Shamie, MD | Section Editor