EyeInstitute

Vision Care Research Education Community

David W. Parke II, M.D. is President andCEO of the McGee Eye Institute. He alsois Edward L. Gaylord Professor andChairman of the Department ofOphthalmology at the University ofOklahoma College of Medicine.

President's Perspective

“IS MY DOCTOR COMPETENT?”Summer, 1999

The Dean A.

examination scores or surgical outcomes.

As the Chair of an academic department, every year Imust certify whether new graduates of our residencyprogram have completed their training in a satisfactoryfashion. Without that certification, they cannot proceed onto possible board certification. We are cognizant of ourresponsibility. A large percentage of Oklahoma’sophthalmologists receive their training here, and wetherefore have a responsibility to the citizens of this stateand to the 24 other states where our graduates practice.

What resources do we have to accomplish thiseducational task? We have a strong medical school behindus. The Dean McGee Eye Institute is a modern facility,completely equipped with state-of-the-art instrumentationavailable nowhere else in this state. Our residents have theopportunity to learn in a multitude of settings — University

Hospital, the VA Hospital, Children’sHospital of Oklahoma, MidtownSurgery Center, and the Instituteitself. We take only three residentseach year from the hundreds whoapply. Each resident has nearly fortyfull-time Department ofOphthalmology and Dean McGee EyeInstitute faculty committed to trainhim or her — one of the highestresident/faculty ratios in the country.

Consider one aspect of the task’scomplexity — how do you determineif a trainee is competent to do cataractsurgery? A very good cataractsurgeon is much more than just atechnician. I daresay that I couldteach a gifted nonphysician toactually technically perform a routinecataract operation. He wouldn’tunderstand what he was doing, whenit should be performed or notperformed, what complicating factorsexist, how to assess the patient’s

f you become ill with a complex disease or need delicate surgery, you may understandably ask this question. Inour case you are trusting your eyes and sometimes yourlife to your ophthalmologist. If, like most Americans, youhave two eyes this is a very important question. If youhave only one eye, this can be infinitely more frightening.A poor outcome can mean blindness forever. Physiciancompetency does not eliminate the possibility ofcomplications, but it stands to reason that it significantlyreduces them.

How do you determine if a physician is competent? Isit having attended a good medical school? A goodresidency? Board certification? Being listed in “BestDoctors in America” or local magazines? Is it the size ofthe office? Should you listen to other patients? Shouldyou believe the quarter page ads some physicians purchaseclaiming “best results” and “most experience?”

There is no absolute gold standard.Doctors themselves will disagree as towho “the best” is in a particular field orat a specific surgical procedure. How dodoctors assess probable competence ifthey don’t have personal knowledge?Doctors themselves tend to give weightto quality of training — specifically tocompletion of a top quality residencyand subsequent board certification.

Now ask yourself the question —“How does the residency programdetermine that a doctor is competent?”This is a core question for wephysician-educators. Competency inophthalmology (and all of medicine)means a lot of things. It includes bookknowledge, judgment, decision-makingcapabilities, and technical aptitude. Itincludes communication skills, ethics, apassion for life-long learning, and astrong sense of personal responsibilityfor patient welfare. Competency istherefore not simply a measure of

I

Continued on page 5

McGeeMcGee

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On August 4 Michael Siatkowski, M.D. joined the DeanMcGee Eye Institute as its new Director of PediatricOphthalmology. A native of Pennsylvania, Dr. Siatkowskijoins the Institute from the full-time faculty of the world-famous Bascom Palmer Eye Institute in Miami.

In addition to having been one of the busiest cliniciansat Bascom Palmer, Dr. Siatkowski is also a seriousclinician-scientist who will attract more nationally-sponsored clinical trials to Oklahoma.

Dr. Siatkowski brings a truly unique set of talents toOklahoma. He is not only fellowship-trained in pediatricophthalmology, but he is fellowship-trained in neuro-ophthalmology, with a particular interest in pediatricneuro-ophthalmology. His primary practice at DeanMcGee will be pediatric ophthalmology and strabismus.

Dr. Siatkowski carries a national reputation forexcellence. In addition to authoring or coauthoring ninebooks and chapters, he has published over thirty scientificpapers in the past seven years. His work has led to a FirstPrize for Research from the Pennsylvania Academy ofOphthalmology and membership in the Alpha OmegaAlpha Medical Honor Society. He has been an invitedlecturer on four different continents.

And he has accomplished all of this before age 35.

DMEI RECRUITS NEW DIRECTOR OF

PEDIATRIC OPHTHALMOLOGY

R. Michael Siatkowski, M.D.

“We are absolutely delighted that Mike Siatkowskichose to come to the McGee Eye Institute in preferenceover all of the other nationally recognized eye instituteswho were fighting for his talents,” said Dr. Parke. “He is abright, energetic rising star in our profession. Equallyimportant, he combines intellectual power with a gentlespirit, calm demeanor, and a sense of humor. He loveschildren, and takes personal responsibility for their care.”

Dr. Siatkowski will see patients in the newly renovatedInstitute pediatric ophthalmology clinic area. This newclinic was funded by a grant from the Keen CharitableTrust. “We truly value the Keen Charitable Trust’scommitment to children’s eye care. Their partnership withus on these renovations will provide Dr. Siatkowski with anexcellent home for his patients,” noted Dr. Parke.

Mike Siatkowski does not come alone to Oklahoma.His wife, Rhea Siatkowski, M.D. is also a superbly trainedand talented ophthalmologist. A native of New York City,she completed both a residency and a fellowship indiseases of the cornea and refractive surgery at BascomPalmer. She, too, will be joining the Institute staff.

“Rhea and I were looking for a place that combined anexciting, nationally recognized eye institute with asupportive, friendly place to raise our family,” said Dr.Siatkowski. “We found it in Oklahoma.”

Rhea L. Siatkowski, M.D.

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The Dean A. McGee Eye Institute

LEGACY OF SIGHT

The Dean McGee Eye Institute is among a small groupof eye institutes nationwide participating in research trialson the latest treatments for age-related maculardegeneration. “Several therapies have evolved which holdnew hope for preserving vision in many patients whoformerly had ‘untreatable’ eyes and were doomed to

gradually lose their vision,” noted Dr. Reagan Bradford, Jr.,Clinical Associate Professor and study co-investigator.

Age-Related Macular Degeneration is the most commoncause of blindness in senior citizens. In its most severe

NEW MACULAR DEGENERATION

CLINICAL TRIALS

In 1992, the Dow Jones Industrial Average closed above4,000 for the first time. This year, in 1999, the Dow hasalready closed above 11,000. This unprecedented increase instock values has created trillions of dollars of new wealth.More and more people are recognizing that as their personalfinancial conditions have been enriched, they now have themeans to provide for the institutions that through their goodworks have benefited their lives and their community.

Gifts to the Dean A. McGee Eye Institute Foundation canbe restricted to vision research, patient care, or educatingtomorrow’s ophthalmologists. The Eye Institute is onlylimited in what it can accomplish by the funding it receives.We have many dreams, but we are limited by the financialresources we receive from the generous gifts from ourpatients and friends.

This is an excellent time to consider supporting the EyeInstitute’s mission through a gift of highly appreciated stock.Gifts of stock can provide a tax-efficient way to makemeaningful gifts with little or no effect on your currentspendable income. Both federal and state laws provide verystrong incentives for making a charitable gift of stock. Infact, greater tax incentives exist for making gifts of stockthan for making gifts of cash.

When you give appreciated stock, you are entitled to anincome tax deduction for the full current value of the stock,not just the amount you paid for it. All capital gains tax thatwould be due on a sale of the stock is avoided. You are, ineffect, allowed to use the “paper profits” in the stock toreduce the amount of income tax you would otherwise owe.

Making a gift of stock (including mutual funds) is a verysimple procedure. Your financial services provider cantransfer stock directly to the Dean A. McGee Eye InstituteFoundation electronically or by stock certificate. In eithercase, we can provide the necessary information needed tomake the transfer to you or your financial advisor.

The Dean A. McGee Eye Institute prides itself on Continued on page 5

providing very special eye care. Its extensive visionresearch programs diligently strive to improve the lives ofgenerations that follow through finding ways to detect,treat, and ultimately prevent blinding eye disease. Yourgifts make possible all that we do.

Please consider making a gift of appreciated stock to theDean A. McGee Eye Institute Foundation. Your gift willdirectly benefit our programs and provide you with a verysignificant tax deduction. We are deeply grateful to ourpatients and friends who have supported the Institute sogenerously.

For more information regarding gifts of appreciatedstock, call or write:

Richard R. Linn, JrVice President for Development

Dean A. McGee Eye Institute608 Stanton L. Young Blvd.Oklahoma City, OK 73104

(405) 271-7801

Photograph shows bleeding under the retina inmacular degeneration.

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OPTICAL SERVICES AT DMEIPart of a complete ophthalmologic examination is

ensuring the patient has the correct glasses prescription.Patients who travel long distances to the Dean McGee EyeInstitute and require new glasses no longer have to goelsewhere to quickly obtain high quality eyeglasses.Officially open for 5+ years, the Institute’s Optical Serviceshas more than tripled its facility size and capability in thepast few months, and now manufactures its lenses on-site.

That ability includes even the most complicatedprescriptions, said Optical Services Director Sheree Lyons.With a staff of three nationally certified opticians, oneoptician trainee, one optician’s assistant and a receptionist,Lyons said turnaround time is rapid, and patients travelinglong distances can arrange to have the lenses preparedwhile they wait. A series of extremely precise computerizedmachines take the frames selected by the patient and mark,grind, polish, tint, add UV protection (if desired), and checkwith a light meter. The lenses are inspected at thecompletion of each stage in the process to ensure both lensaccuracy and cosmetic appearance. The result — finishedeyeglasses of the highest quality.

“When you go to a one-hour place the quality of thelenses can really become an issue,” Lyons noted. “For us,having this ability on site is really about control of theproduct. We can better assure that our patients are receivingexactly the prescription and type of lens they need.”Despite a focus on optical quality, style and patient choiceremain important priorities. DMEI’s Optical Servicesmaintains a selection of more than 1,000 frames, including

designer frames and frames for children. “Anotheradvantage of our ability to make glasses on-site is thatmany patients only need one lens,” Lyons said. “With someprior notification, we can easily handle that here bypreordering the lens and grinding while they wait. That waythe patient is never without their glasses. This isparticularly useful for our patients who travel from the ruralparts of the state.” For more information about OpticalServices, call Lyons at (405) 271-6174.

ANN A. WARN, M.D.A special location and a special

population keep work busy andchallenging for Dr. Ann Acers Warn,of the Dean McGee Eye Institute’sLawton Clinic. A Lawton native, Dr.Warn completed her training atBaylor University, the University ofKansas College of Medicine, andresidency at the University ofOklahoma College of Medicine/DMEI. She moved to Lawton tohelp establish the Institute’s Lawton

clinic in November of 1994. She now resides in Lawtonwith her spouse, Brett R. Warn, D.D.S., and their twochildren, Brittany age 3 and Pierce age 8 months. Warnconducts a general ophthalmology practice combined withophthalmic surgery.

“During medical school I became interested in severalareas,” Warn said. “Ophthalmology was appealing to mebecause it is a field where one can often truly help a patientand improve their quality of life by improving their qualityof vision. It is also an exciting field because the technologyis always changing and improving.”

Warn’s current project involves working withOklahoma’s many Native Americans as an examiner for theInstitute’s Vision Keepers program. A joint effort with theOklahoma Medical Research Foundation, the project iskeeping track of the incidence of eye disease in NativeAmericans. (Native Americans are considered at high riskfor eye problems, since many also suffer from diabetesmellitus.) Approximately 1,200 Native Americans havebeen examined to date and are now being examined asecond time to assess possible disease progression.

Others besides DMEI’s Lawton patients have noticedWarn’s abilities. She was one of the first two women toearn membership in the American Eye Study Club, and inaddition to other professional activities, serves as EyePACchair for the Oklahoma Academy of Ophthalmology. Shehas also gone back to school to earn a Masters in BusinessAdministration (M.B.A. degree) to assist the Institute inmanaging the complex business of medicine.

“Dr. Warn was born in Lawton and raised in Oklahomaand has a tremendous love for the people of herhometown,” said Dr. David W. Parke II, DMEI Presidentand CEO. “As a resident she impressed our faculty withher knowledge and clinical skills, but, more importantly,with her strong sense of personal responsibility for patientcare. We have since come to appreciate her leadershipability and her spirit of commitment to her profession.Ann is also one of the world’s nicest people. The Instituteis very fortunate that she was excited to return to Lawtonto direct the establishment of our facility there.”

DMEI FACULTY PROFILE:

Ann A. Warn, M.D.

Steve Lynch, A.B.O.C.

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form, called exudative macular degeneration, abnormalblood vessel growth occurs underneath the eye’s centralretina (see related research article on page 6) and oftenleads to rapid loss of central vision used for reading,driving and straight-ahead sight. Some patients, Bradfordnoted, now may possibly be successfully treated withnewer forms of laser surgery, postponing or avoiding lossof vision. Candidates for this treatment are patients whoseabnormal blood vessel growth (neovascularization)extends under the central retina and would not be treatableusing conventional laser methods.

The Institute is now participating in the nationalMiravant trial, one of several new exciting therapies beingtested, which offer hope for patients with these“untreatable” eyes. The Miravant study evaluates a type ofphotodynamic therapy (PDT), wherein patients receive anintravenous injection of a drug that sensitizes theabnormal blood vessel growth to the effects of low energylaser light. Laser treatment of the sensitized tissue thenmay help slow or even stop the leakage from these bloodvessels, in turn resulting in stable or improved vision.Institute retina specialists anticipate participating in aseparate trial of a related medication, Visudyne, bySeptember.

In the second study, the Subretinal Surgery Trial(SST), the Institute is evaluating the use of submacularsurgery. In submacular surgery, the abnormal bloodvessels are surgically removed from beneath the innerlining of the back of the eye (retina). This study is beingorganized and conducted by the National Eye Institute ofthe National Institutes of Health. Dean McGee EyeInstitute retina specialists have been performing thissurgery on carefully selected patients for over one yearand are experienced in the technique. This study willdetermine whether this form of surgery is helpful topatients with a specific subgroup of macular degeneration.

A third study underway evaluates the use of retinallaser treatment in a fashion similar to that employed forcertain forms of diabetic retinopathy, so-called panretinalphotocoagulation (PRP). Like the Miravant study, thistreatment aims at stopping the leakage from the abnormalvascular tissue beneath the retina, in order to helpmaintain good visual function.

Patients are being sought to participate in all threestudies. If you or your doctor believe you have active newblood vessel growth under the center vision from maculardegeneration, you may be a candidate for one of thesestudies. Patients will be evaluated in clinic, and thosefound to have neovascularization under the retina, whichis untreatable by conventional laser techniques, may beeligible to participate.

For more information, call DMEI Clinical Trials at(405) 271-6307.

Macular Degeneration, continued from page 3

related medical conditions, how to measure success, howto recognize and manage complications, and how tocontinually improve technique. Therefore, acquiringsurgical competence is much, much more than simplywatching some operations and ultimately “soloing” —with faculty in attendance.

How many cataract operations must the residentperform before he or she is technically competent? Therequired national minimum is 35. We mandate a minimumof 100, and our residents each do substantially more.

Yet numbers alone mean little. I have seen residentswho after 20 supervised cataract operations are simplyoutstanding. I’ve also seen residents who even after 60were nervous and hesitant, and who still benefited greatlyfrom the presence of faculty in the operating room. Theyhad not yet acquired confidence and fluidity of motion.Confidence should not be confused with overconfidence.The very good surgeons continually criticize their ownwork, search for imperfections, and seek to learn fromothers and improve their techniques.

We take our jobs as educators very seriously. We startwith incredibly bright, young physicians. It is ourresponsibility to teach them the science and skills ofophthalmology and at the same time imbue them with arespect for the profession and for the patient. In the endwe must weigh all the factors and judge whether we canproudly offer them to the community as physicians whowill competently serve their patients’ needs.

Perspective, continued from page 1

Dr. Parke introduces Edward McManus from the National EyeInstitute at the “Celebration of Vision” exhibit at Omniplex.Over 40,000 Oklahomans viewed this DMEI-sponsoredprogram on the art and science of vision.

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FINDING ANSWERS TO DISEASE AT THE

MOLECULAR LEVELIn order to find sweeping cures for any serious

disease (including the various causes of blindness)tremendous amounts of knowledge first must be acquiredat the most basic level of the body — the genes ofindividual cells. Individual genes within the cells are theblueprints for the production of proteins which permit theunique functioning of different cells. The genes of someretinal cells, for example, produce a protein whichstimulates blood vessels to grow, thus providing oxygenand nutrients to the inner part of the eye. Yet the samegene in a lung cell is “turned off” and produces no suchsubstance. Studying this process leads to all types ofquestions involving how the genes function in normalhealth, and how they cause disease.

Scientists at the Dean McGee Eye Institute areheavily involved in such basic research. John Ash, Ph.D.recently joined the Institute research faculty from BaylorCollege of Medicine. He in particular works to offer newhope for the 14 million Americans who suffer fromdiabetes mellitus, and in particular the 40,000 diabeticswho will go blind each year due to a commoncomplication — diabetic retinopathy.

Ash’s work explores how tissues in the body controlthe growth and function of their network of bloodvessels, more specifically known as the body’s vascularsystem. Many diseases and even death are the end resultof abnormalities which cause the body to lose the ability

to regulate its vascular system. Some key examples areheart disease and cancer. In the field of ophthalmology,vascular problems are a key factor of blindness and visionproblems caused by diabetes, retinitis pigmentosa, age-related macular degeneration (see related article, page 3),and conditions found in premature infants.

“Many of the diseases associated with the growth ofabnormal blood vessels could be helped if we had theappropriate means to prevent abnormal growth and torestore normal blood vessel integrity once it has beendamaged,” Ash said. “In addition to its importance intreating vision loss, inhibiting growth of blood vessels hasbecome the newest and most promising therapeutic strategyto controlling the growth of tumors in patients withadvanced cancer. And there are implications for many otherdiseases as well.”

In the eye, blindness can be the end result of damage tothe retina due to growth of abnormal blood vessels. Beforephysicians can use therapies designed to regulate bloodvessel growth, they first must identify the interactionbetween specific growth factors required to stop abnormalgrowth and those required to promote proper blood vesselfunction. Prior studies have identified an expanding list ofgrowth factors essential to vascular development. They alsohave revealed chemical “signals” in the body that bothpromote and inhibit blood vessel development, Ashexplained. Using this knowledge base and using the eye asa model, Ash is conducting studies to help identify more ofthese growth factors and determine how multiple groups ofgrowth factors can interact to promote growth,maintenance, and function of normal blood vessels. Hiswork is funded through grants from the National EyeInstitute, part of the National Institutes of Health, plus TheOklahoma Center for the Advancement of Science andTechnology (OCAST), as well as by DMEI.

“An accepted hypothesis among scientists right now isthat in normal tissues the body provides growth factors tothe blood vessels, causing them to maintain integrity andfunction, and to prevent abnormal growth,” Ash said. “Inpatients with certain types of disease, including diabetes,these body tissues may lose the ability to provide a criticalgrowth factor to promote healthy blood vessels. Or, instead,the body actually may provide an abnormal growth factor,which in turn promotes abnormal blood vessels. We aremaking substantial progress in the laboratory. Our long-term goal is to identify these factors and our ultimate goal,of course, is to use this information to develop treatmentstrategies for our patients.”

Molecular biology research at DMEI involves a largeresearch team including James F. McGinnis, Ph.D., Julesand Doris Stein Professor, Department of Ophthalmology.

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Victoria Carrasco has always been anaccomplished artist. She had beendoodling, drawing sketches and paintingfor as long as she can remember. NowCarrasco, 50, is the Dean of the Art Schoolat Central University in Quito, Ecuador,her home city. In a visual industry, this ispretty amazing for a woman who has beenlegally blind in her left eye and nearlyblind in her right eye for 10-15 years. Buta recent trip to Oklahoma, where as aFulbright Scholar she was a visitingprofessor, has changed her life forever.

In an effort to correct her visionproblems, Carrasco had a corneatransplant over 20 years ago. But shesubsequently developed complicatedcataracts and her vision had failed.During her stay in Oklahoma City, shecame to the Dean A. McGee Eye Instituteand saw Bradley K. Farris, M.D., Professor ofOphthalmology. Despite the complications related to herprior surgeries, Dr. Farris felt that surgery with intraocularlens implantation offered her the best chance for vision.However, because of her situation, there was a significantlygreater than usual chance of postoperative problems andblindness.

Ms. Carrasco’s difficulty in finding surgical help hadbeen compounded by financial difficulties. To help her,Farris and Surgicare Midtown agreed to waive any feesassociated with the surgery while Alcon Corporationagreed to donate the intraocular lens.

“I have had bad vision for as long as I can remember,”said Carrasco. “It has been very hard to teach and continuemy art; I just had to find ways to work around it.”

Farris decided to perform surgery on the left eye first.Her vision in that eye had deteriorated to 20/200 — legallyblind. In the delicate surgery, Farris removed the cataractand replaced her lens with a lens implant. Within a fewdays, a woman who desperately needed good vision for herprofession had perfect vision — 20/20. Successful surgerywas then immediately performed on the right eye.

“When we first took the bandages off her left eye, shestarted crying, took my hand and pulled me to her and

hugged me,” Farris said. “It was the first time she couldremember seeing clearly in decades. Now she has beencorrected to 20/20 in both eyes and has very little need forglasses.”

“Oh it is wonderful. I am very grateful to Dr. Farrisand Surgicare Midtown; it has given me a new life. Beforethe surgery I had a lot of problems seeing, but now I cansee perfectly,” said Carrasco, who recently returned to hernative Ecuador. “I have had bad vision my whole life. Butthis surgery should help me with my artwork and myteaching. This has been a very important turn in my life.”

Before returning home, Carrasco’s work was exhibitedat a large art show. She requested Farris accept a piece ofart on exhibit as appreciation for his work. Carrascobrought three large sections of a mural she had beenworking on for years. It is made on copper tiles, handpainted and enameled. Interestingly, the huge mural,which is now on display at Dean McGee, was made whileCarrasco was legally blind.

“The piece is just beautiful,” Farris said. “I amthankful to her and proud to display it at the Institute. Thisis why I went into medicine; it is wonderful to helpsomebody and get a good result. Victoria gave credit toGod, and so do we.”

SURGERY AT DMEI ALLOWS

SOUTH AMERICAN ARTIST TO SEE AGAIN

Dr. Farris and Ms. Carrasco next to her mural

DMEI TELEPHONE DIRECTORY

OKLAHOMA CITY608 Stanton L. Young Boulevard

EDMOND301 S. Boulevard, Suite 119

LAWTONTomlinson Medical Complex3201 W. Gore Blvd., Ste. 105

Cornea and Refractive Surgery(405) 271-1095James Chodosh, M.D.Rhea L. Siatkowski, M.D.Thomas C. Wolf, M.D.

General Ophthalmology(405) 271-1090Hal D. Balyeat, M.D.Cynthia A. Bradford, M.D.Robert P. Shaver, M.D.

Glaucoma(405) 271-1093Gregory L. Skuta, M.D.

Low Vision(405) 271-7834Rebecca K. Morgan, M.D.

Neuro-Ophthalmology(405) 271-1091Bradley K. Farris, M.D.R. Michael Siatkowski, M.D.

Ocular Prosthetics(405) 271-3391Nancy A. Townsend, B.C.O.

Oculoplastic Surgery(405) 271-1096Scott C. Sigler, M.D.Robert G. Small, M.D.

Optical Services Spectacles, Low Vision Aids Contact Lenses(405) 271-6174Sheree Lyons, A.B.O.C.

MIDWEST CITY8121 National Ave., #407

NORTHWEST OKC3500 N.W. 56th, #101

General OphthalmologyOphthalmic Surgery(405) 250-5855Ann A. Warn, M.D.

General OphthalmologyOphthalmic SurgeryContact Lens Services(405) 271-9500Layne E. Goetzinger, M.D.Ralph B. Hester III, M.D.Mika M. Hague, N.C.L.C.

Dean A. McGee Eye Institute608 Stanton L. Young BoulevardOklahoma City, Oklahoma 73104

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Matt Venard, F.C.L.S.A.Jean Ann Vickery, F.C.L.S.A.

Pediatric Ophthalmology/ Strabismus(405) 271-1094R. Michael Siatkowski, M.D.

Retina/Vitreous(405) 271-1092Reagan H. Bradford, Jr., M.D.Ronald M. Kingsley, M.D.Sumit K. Nanda, M.D.David W. Parke II, M.D.

Trauma/EmergencyGeneral Inquiries(405) 271-6060

General OphthalmologyOphthalmic SurgeryContact Lens Services(405) 348-0913Diana H. Locher, M.D.Jeffrey T. Shaver, M.D.Jean Ann Vickery, F.C.L.S.A.

General OphthalmologyOphthalmic SurgeryContact Lens Services(405) 733-4545Darrell J. Pickard, M.D.R. Randall Robinson, M.D.Wanda A. Fisher, N.C.L.C.