Dr. Singer To Perform Eye-Tech Implants

Eyesight fading? Hate those reading glasses? Considering laser vision correction?

You might want to wait for a new generation of "intraocular" (in the eye) options that will soon be available right in Randolph.

Randolph ophthalmologist Dr. Jack A. Singer, who last month opened a solo practice on Randolph’s South Main Street, plans to be one of the first in New England to offer several breakthrough lens-implant procedures to correct vision.

Singer, who enjoys an international reputation as a cataract surgeon, believes that these new implant options will supplant the "laser vision correction" that is widely promoted now.

Anticipating a big demand for new lens-implant techniques to correct vision, Singer has designed his new private practice, in part, to meet that future.

In a joint venture with property owner Richard Forbes, Singer has recently transformed the "chapel" on the Mari-Castle into a state-of-the-art ophthalmology office. The octagonal building, now divided into a series of examining rooms, opened as "Singer Eye Center" on April 17.

Previously, Singer had practiced for 18 years just across the street, in an ophthalmology office operated by the Dartmouth-Hitchcock medical system. Ophthalmologist Christopher Soares continues to practice in that office, offering a full range of services, including pediatric and cataract eye surgery.

As a private physician, Singer will continue to perform surgeries at Gifford Medical Center, as he has since 1985.

The new technologies that Dr. Singer is gearing up to offer include an "accommodative" lens implant that responds to eye muscles, and thereby is able to adjust for near and far vision, and anywhere in-between.

Singer explained that up until now, predominantly single-focus lenses have been available in this country. Cataract patients, for example, routinely give up their clouded human lenses for clear lens implants that give them terrific long vision, but they still need reading glasses for close work.

The new variable-focus lenses, however, will not be just for those with cataracts. Singer anticipates a big demand for these implants from folks 45-65 years of age, whose eyes are losing the ability to "accommodate" for both near and distance vision. These are people with presbyopia, who, at a certain age, need reading glasses or bifocals.

According to Singer, this lens-implant approach to vision correction comes with a side-benefit: freedom from a future with cataracts. Just about everybody who lives long enough will get cataracts—a clouding of the human lens. Those who have their vision corrected by lens implants will escape not only cataracts, but also the years of worsening vision that precedes cataract surgery, Singer claimed.

Singer plans to offer accommodative lens implants following their anticipated FDA approval later this year.

Singer also plans to offer other implant innovations on the horizon, including light-adjustable lenses and implantable contact lenses.

‘Super Vision’

Light-adjustable lenses can be fine-tuned by laser—after implanted in the eye—to perfect the patient’s vision, even to the point "super vision." Singer anticipates these adjustable lenses will be available in a few years.

Implantable contact lenses, which are placed near the human lens inside the eye, would replace glasses or contacts for younger patients whose eyes still have the ability to "accommodate." These lenses, already available in Canada and Europe, will likely be FDA-approved later this year, Singer said.

These new intraocular procedures are distinct from "laser vision correction." That procedure adjusts vision by using a laser to reshape the cornea, the clear "front window" of the eye. According to Singer, correction by lens implant can give the patient superior vision to that offered by laser reshaping.

Currently, 95% of the 500 or so surgeries Singer performs annually are cataract surgeries, which are themselves an implant procedure. In 10 years, Singer projects, 50% of the surgeries he performs will be refractive—that is, surgery to improve the focusing abilities of the eye.

As "one of a select group of practices involved in the research and clinical investigation of the latest intraocular lens designs and cataract removal technologies," Singer said, he is well-positioned to offer the new vision-correction lenses before they become widely available to the general public.

Without a doubt, the soft-spoken Singer is a high-profile guy in the ophthalmologic world. Since he came to Randolph in 1985, Singer has trained eye surgeons from all over the world in his cataract surgery techniques and innovations.

"Cataracts are still the most common cause of blindness in the world," Singer noted. "There are so many cases and so few surgeons who know how to do the surgery effectively and efficiently."

Singer regularly presents papers at the American Society of Cataract and Refractive Surgery, and has won awards five times for his surgical films.

In 1996, he was instrumental in amending U.S. patent laws, to ensure that new medical discoveries could be freely shared among physicians and widely available to the public.

Singer’s move to a private practice, after years of being a Dartmouth-Hitchcock employee, occurred after a year of research and planning. Singer enlisted one of his patients, retired businessman Bill Markle of Braintree, to help him develop a business plan.

Testimonial

After months of preparation, a bank appointment to seek financing for Singer’s new business was set—for one day after Markle was scheduled for eye surgery. "A very happy post-operative patient" accompanied Singer to the meeting, at Randolph National Bank.

Markle "seeing better than he had for years" and "astounded by the colors" made a favorable impression on the loan officers, Singer noted with a grin. The loans, for the renovations and the business start-up, were approved.

High-Tech Tools

Designed with an eye surgeon’s attention to detail and constructed with meticulous care, Singer Eye Care is also equipped, throughout, with the latest technology.

To ensure precise measurement of the eye pre-operatively, Dr. Singer has installed several new measuring devices, which variously use laser light, infrared light, and ultrasound. More accurate measurements, he explained, allow the surgeon to calculate the precise lens implant power needed for the patient.

To measure refraction—the "focusing state" of patients’ eyes— Singer uses a high-precision digital system that makes it easier for patients to select the best focus, by presenting two options to the eye at once.

Singer’s favorite new tool is a digital "slit lamp" imaging microscope that takes detailed pictures of the eye as Singer performs the examination.

The diagnostic equipment in the "paperless" office is linked to a 13-station computer network, and all data and digital images are automatically entered into patient records. The digital system also allows Singer to send data and images to referring physicians.

In a demonstration of the digital "slit lamp" during a recent tour, Singer took a picture of the iris of ophthalmic technician and surgical assistant Cookie Hall. A vivid, color image of Hall’s eye—14 inches across—appeared on the computer screen. (Other employees are Jennifer Young, administrator; Sherri O’Connell, medical secretary; and Cynthia Legacy, ophthalmic assistant.)

An open house is planned in June.

General contractor for the construction was William Kevan of Randolph.

By Sandy Cooch