EyeWorld India June 2015 Issue

71 EWAP NEWS & OPINION June 2015 In 1965, Dr. Kratz testified at a U.S. Senate hearing and helped defeat a bill that would have made it illegal for ophthalmologists to fit contact lenses or to dispense glasses in their offices and would require patients to go to optometrists or opticians for those services. Despite opposition after the invention of phacoemulsification, Dr. Kratz helped to pioneer its use. Despite objections from Medicare, the U.S. Food and Drug Administration, and some senior academic ophthalmologists, he helped to develop, teach, and defend the use of both phaco and intraocular lenses. Along with Dr. Sinskey, he was a cofounder of a course that taught the phaco technique to more than 4,000 ophthalmologists from all over the world. The course simplified the procedure by moving the emulsification from the anterior chamber to the plane of the iris to protect the corneal endothelium. Dr. Kratz and Dr. Sinskey developed the two-handed technique, the scleral tunnel incision, hydrodissection of the nucleus, and the polishing of the posterior capsule. They also made many modifications of the phaco machine and surgical instruments. Dr. Kratz was clinical professor of ophthalmology at the University of Southern California, Los Angeles, and University of California, Irvine. He never patented any intraocular lenses, devices, or instruments and declined the honor of being chairman of the Department of Ophthalmology at the University of California and president of ASCRS. After his retirement from the practice of medicine Dr. Kratz was active at the University of California, Irvine in the Department of Ophthalmology Steering Committee and on the Beckman Laser Institute’s Board of Directors. With us, “The Three Amigos,” he attended meetings of the ASCRS, American Academy of Ophthalmology (AAO), American Academy of Anti-Aging Medicine, and other organizations every year. Dr. Mazzocco worked with Dr. Kratz in practice, beginning in 1973, while Dr. Honan was a longtime friend. We three shared many discussions, memories, and debates during our time spent together. The genuine sincerity and graciousness of Dr. Kratz extended to and was felt by every person with whom he had contact. He engendered instant friendship with each new person he met. His deeply engrained sense of integrity and honesty were paramount and pervaded his every thought and behavior. To Norman S. Jaffe, MD by Kenneth J. Hoffer, M D W hy does every eye surgeon around the world owe a huge debt of gratitude to Norman S. Jaffe, MD ? It is quite simple. He was a very special person with a uniquely inspiring personality and intellect that caused others to respect him and his judgment. I knew very few who had the courage to question Norman, especially this 30-year-old, 2 years out of residency in 1974. In 1974, when I performed my first lens implants, few ophthalmologists respected the couple of hundred who were implanting these “foreign bodies” or as Richard Troutman called them, “intraocular time bombs.” Discussions on the subject were not allowed at major meetings in the U.S., nor were papers accepted for publication in the respected journals of the day. I knew this field could not advance without such open discussion and proceeded to put together an organization I called the American Intra-Ocular Implant Society (AIOIS) and incorporated it in California in August 1974. Our original group of four organizers decided to put together a Scientific Advisory Board that could make decisions but have no real corporate power. To do this, we put together a list of all those we had ever heard of doing IOLs. When we finished, we culled it down to 13 people. We divided up the phone calls and contacted each of them personally. There was one I kept for myself: Norman Jaffe. I was totally intimidated but after asking him to be part of it, he questioned me intensely as to my motivations and intentions. When we finished, he said he would “think about it.” Eventually, I called him back and told him that the AIOIS stationary was going to the printers with or without his name on it and he had one week to make his decision. I told him “the train is leaving the station.” He finally said yes and I was very relieved. I knew this would make all the difference. During my first year as president, a major goal I had for AIOIS was that Norman Jaffe take over the presidency in 1975 just as we were facing the California U.S. Food and Drug Administration (FDA) putting a stop to making or selling IOLs. Since most manufacturers were in California, that would put a practical end to IOLs nationwide. He demurred my requests for quite some time but then suddenly after months of prodding him, he accepted. The timing was perfect and he was the perfect man for the time. He immediately took up the challenge to stop the California FDA from blocking IOLs. Together we hired an attorney he recommended from New Orleans who investigated our situation and presented us with the issues and options at a forum at Santa Monica Hospital. From this we persuaded Henry Hirschman and Mary Kay Michelis to hire San Diego attorney Ted Pulaski to file a lawsuit against the State in Superior Court. We asked Robert Hubble to form the Intraocular Lens Manufacturers Association (ILMA) bringing in all the manufacturers. We asked the game show host Gene Rayburn (my patient) to head an organization we called the Patients and Friends of Intraocular Lenses. Norman and I kept the AIOIS completely out of all legal affairs but did keep the membership informed as to what was happening. It was a trying time, but Norman’s leadership pulled us through the tough parts—he was perfect. On 22 August 1975, Superior Court Judge Harry Hupp issued a preliminary injunction preventing the California FDA from carrying out its plans. That injunction holds to this day. It still wasn’t over. Since the U.S. FDA was behind the California action, they decided they had to now get into it with us. AIOIS pulled all the influence we had to see that any future FDA device legislation did not prevent IOL use. There were congressional hearings, and Ralph Nader’s group was out to stop IOLs as a health hazard, and they really believed it was. They had Sidney Wolf, MD, testifying to how bad they continued on page 72