Download The Bochner Eye Institute: Past, Present, and Future

OPHTHALMOLOGY
G E N E R A L I N T E R E S T A RT I C L E
The Bochner Eye Institute: Past, Present, and Future
Y. Ali Khan, RO
O
nce a private home in the early 1900s, the historic building situated in Toronto’s prestigious
downtown on Prince Arthur features an
elegant, renovated facade. But it’s what is inside that is
truly eye-catching; amid the opulent furnishings and
tasteful decor is a high-tech laser and surgical centre
housing the most advanced vision-correction equipment.
Toronto’s Maxwell K. Bochner Eye Institute pays
tribute to its namesake, one of Canada’s most revered
pioneer ophthalmologists, by promoting clinical excellence and providing convenient outpatient surgery and
optimal levels of patient care. At the entrance of the Eye
Institute’s gracious old building you are greeted by a
picture of Dr. Bochner. The high ceilings, stained glass
windows, and oak staircases of the past remain, and
modern furnishings and selected Impressionist reproductions have been added to the facility.
The Legend - Dr. M.K. Bochner
The Bochner Eye Institute was established and founded
in 1929 by Dr. Maxwell Bochner. While Dr. Bochner was
one of the earliest surgeons to specialize in diseases of
the eye, he was also one of the nation’s leading ophthalmologists until his death in 1968. When performing
cataract surgery and diagnosing eye disorders, he was
able to recognize symptoms of other serious disorders of
the body by examining only the eyes. This capacity was
truly revolutionary more than 50 years ago.
In 1929 Dr. Maxwell K. Bochner became the first
trained ophthalmologist in Canada after graduating from
the University of Pennsylvania’s famed Will’s Eye
Hospital. In the past, the specialty included eyes, ear,
nose, and throat, but Dr. Bochner devoted his entire
career to ophthalmology alone. In 1936 he became the
first Chief of Staff at the Mount Sinai Hospital - a position he held for 40 years. At the same time, he also
became the founder of the Scarborough General
Hospital under the Sisters of Misercorde; he was also its
Chief of Staff. He was the first physician in Canada to
hold the Chief of Staff position at 2 major hospitals at
the same time.
His innovative thinking coupled with diligent yet
gentle patient care is a legacy Dr. Bochner has passed
on to the Institute’s practitioners and patients. His
acumen, which has been repeatedly demonstrated by
pioneering techniques in vision correction and a continual investment in state of the art laser technology, is
also why other physicians regularly come to the
Bochner Eye Institute. In fact, they come not only to
learn about new techniques and technologies, but
sometimes to seek treatment for themselves.
12
AOE • Academy of Ophthalmic Education
Dr. Bochner’s humility and humanity were hallmarks
of a great man. He was an outstanding physician and
ophthalmologist but, most of all, he was an unusual
human being whose first concern was for people.
Currently, two tangible expressions of the devotion and
respect of his hospital colleagues are the Maxwell Kurt
Bochner shelf in the Ophthalmology section of the
Mount Sinai Hospital’s Medical Library, and a portrait of
Dr. Bochner that hangs in a place of honour in the
lobbies of both the Mount Sinai Hospital and the
Scarborough General Hospital.
Today, the Bochner Eye Institute houses numerous
programs for preventative medicine, active treatment,
and research and education. In order to maintain clinical excellence in light of today’s continuing technological advances, the medical directors of the institute - Dr.
Harold Stein, Dr. Albert Cheskes, and Dr. Raymond
Stein - offer the latest in vision enhancement, including
the newly introduced state-of-the-art Allegretto 400 KHz
blue line and VISX S4 with iris registration lasers, which
are used to correct nearsightedness, farsightedness, and
astigmatism.
Dr. Harold Stein joins Dr. Bochner at the
Bochner Eye Institute
Dr. Harold Stein is a graduate of the University of
Toronto Medical School. After completing an internship
at Mount Sinai Hospital in Toronto, he received a fellowship to study ophthalmology and ophthalmic
surgery at the prestigious Mayo Clinic in Rochester,
Minnesota. Dr. Stein also received a Master of Science
degree from the University of Minnesota, and a fellowship in the Royal College of Surgeons. Later he became
qualified as a plastic surgeon after studying with worldrenowned plastic surgeon Professor Pomfret Kilner in
Oxford, England. In Toronto, he began practicing with
Dr. Maxwell K. Bochner, working side by side with the
Bochner Eye Institute’s founder for over ten years. Dr.
Stein was soon recognized by the medical community
for expertise in cataract surgery, corneal transplants,
contact lenses, and later, refractive surgery.
Over the years, he has been a major international
force in contact lenses, having been one of the first to
initiate and pioneer the soft aphakic contact lens in the
days of intracapsular surgery. He was one of the first to
introduce intraocular lenses in Canada, and they
became state of the art in cataract surgery. Initially, he
imported lenses from Russia and Holland until America
took its lead role in implant manufacturing. Dr. Stein
has served as the Chief of Ophthalmology for over 35
years at Scarborough General Hospital, Scarborough
Ontario.
OPHTHALMOLOGY
G E N E R A L I N T E R E S T A RT I C L E
Dr. Stein is credited with developing the professional
role and educational format of the Ophthalmic Assistant
in Canada and the United States. Recognizing a need for
ancillary personnel in ophthalmology, he developed an
office ophthalmic assistant’s role in the early 1960s.
Later, working with Centennial College in Toronto, he
began the world’s first Ophthalmic Assistant’s education
program. He also co-wrote (as senior author) the first
ophthalmic assistant’s textbook, now in its eighth
edition. This expanded the role of the ophthalmologist
in the delivery of eye care and provided a new field of
endeavor for young professionals in the eye care field.
Over the years, Dr. Harold Stein has been invited to
speak about cataract, contact lenses, and laser eye
surgery at medical meetings and conferences around
the world. As a tribute to his professional status, “The
Harold Stein Lecture” was created by three separate eye
organizations in Canada and the United States.
Dr. Stein’s commitments extend to developing countries where he has volunteered to perform delicate eye
surgery in areas where blindness is rampant. In addition, he has donated his time to teach doctors and other
medical professionals in several countries about
improved treatments, techniques, and technology.
The Bochner Eye Institute and the role of some of its
leading ophthalmologists will be explored in two subsequent publications of Eye Care Review.
Corresponding author:
Y. Ali Khan, RO
[email protected]
AOE • Academy of Ophthalmic Education
13
The Bochner Eye Institute: Part II
Y. Ali Khan, RO
Dr. Albert Cheskes Joins the Practice
D
r. Albert Cheskes joined the Bochner Eye
Institute with Dr. Harold Stein and Dr. Maxwell
Bochner in 1966.
While growing up in Toronto, Dr. Albert Cheskes and
his family were patients of Dr. Maxwell Bochner, the
founder of the Bochner practice. In fact, Dr. Bochner is
credited with saving the life of Dr. Cheskes’s mother
when he detected a kidney problem while examining
her eyes in the 1920s.
Dr. Cheskes graduated from the University of Toronto,
Faculty of Medicine in 1961. From 1963 to 1966 he
trained as a resident in ophthalmology at the Mayo
Clinic. He also received a Master of Science degree from
the University of Minnesota, doing corneal research.
Dr. Cheskes is a highly respected expert in cataract
implant surgery, consultative ophthalmology, ophthalmic surgery, and laser refractive surgery.
Throughout his career, Dr. Cheskes has been a pioneer
in the field of ophthalmic surgery. He witnessed the first
experiments with keratomileusis (an early form of
corneal refractive surgery) in the early 1960s, and along
with Drs. Harold and Raymond Stein, was one of the
first surgeons in Canada to perform laser vision correction procedures. Since then he has performed many
thousands of excimer laser refractive procedures.
Dr. Cheskes is an assistant professor of ophthalmology at the University of Toronto and is an active staff
member at St. Michael’s Hospital in Toronto. He is also
on the ophthalmology staff at Sunnybrook Hospital and
Scarborough General Hospital.
Dr. Cheskes was previously the Chief of
Ophthalmology at Centenary Health Center, as well as
the Chair of the Eye Safety Committee of the Canadian
Ophthalmology Association for many years, acting as an
advocate for public safety in ophthalmology. Dr.
Cheskes, his wife, and their three children are all longtime Toronto residents and are very much involved in
their communities.
Dr. Raymond Stein Joins the Practice
Dr. Raymond Stein began practicing at the Bochner Eye
Institute in 1986, alongside Dr. Harold Stein and Dr.
Albert Cheskes. Since graduating from the University of
Toronto’s Faculty of Medicine in 1982, Dr. Stein has distinguished himself in the highest manner both academically and professionally.
Upon completing his residency in ophthalmology in
1986 at the Mayo Clinic in Rochester, Minnesota, he was
chosen for a one-year fellowship in cornea & external
diseases at the renowned Wills Eye Hospital in
Philadelphia, Pennsylvania. In 1987, he became a
Fellow of the Royal College of Surgeons, Canada, and a
diplomat at the American Board of Ophthalmology.
Dr. Stein currently serves as Medical Director for
the Bochner Eye Institute. He is also Chief of
Ophthalmology at Scarborough Hospital in Toronto;
Cornea Consultant at Mount Sinai Hospital in Toronto;
Assistant Professor of Ophthalmology at the University
of Toronto; and Past President of the Canadian Society
of Cataract & Refractive Surgery. He is the editor of the
scientific journal Clinical and Surgical Ophthalmology.
Dr. Stein is licensed to practice ophthalmology in
Ontario, New York, Arizona, and Minnesota.
Dr. Stein brings his international reputation to the
Bochner Eye Institute, for his pioneering work in
excimer laser surgery, implant surgery, and keratoconus
treatments. Dr. Stein has performed thousands of
cataract & laser surgery procedures, lectured extensively
to professional colleagues around the world, and has
published numerous books, scientific papers, magazine
articles, and book chapters on the latest techniques of
vision correction. He has received awards from various
international organizations including the American
Academy of Ophthalmology, the International
Intraocular Implant Club, and the Contact Lens
Association of Ophthalmologists. He was selected by
three international organizations to deliver the Harold
Stein Lecture in Montreal, New Orleans, and Las Vegas.
He was recently chosen as the eye surgeon for the television show, ‘Style by Jury.’
Throughout his career, Dr. Stein has demonstrated a
commitment to excellence in clinical research, education, and patient care.
Dr. Jordan Cheskes joins the practice
Dr. Jordan Cheskes, son of Dr. Albert Cheskes, joined
the fold in 2001 after completing a 4-year residency at
the Mayo Clinic in Rochester, Minnesota, and a retinal
fellowship at the University of Toronto.
Dr. Jordan Cheskes specializes in medical and surgical retina, to round out the practice. He has been active
in offering the newest treatment modalities for retinal
diseases. As the newest member of the team, Dr. Jordan
Cheskes serves as Chief of the Retinal Division for both
the Scarborough Eye Associates and the Bochner Eye
Institute. He also practices at St. Michaels’s Hospital and
is the Chief of Ophthalmology at Centenary Hospital.
Dr. Cheskes is a lecturer for the Department of
Ophthalmology at the University of Toronto and is often
asked to speak at professional meetings.
AOE • Academy of Ophthalmic Education
17
OPHTHALMOLOGY
G E N E R A L I N T E R E S T A RT I C L E
OPHTHALMOLOGY
G E N E R A L I N T E R E S T A RT I C L E
From left to right: Dr. Harold Stein, Dr. Albert
Cheskes and Dr. Raymond Stein.
Vision for the Future
Dr. Harold Stein, Dr. Albert Cheskes, Dr. Raymond
Stein, and Dr. Jordan Cheskes all attended medical
school in Toronto and continued on at the Mayo Clinic,
from which they all graduated. All four men now hold
faculty positions at the University of Toronto.
Combined, they have over 100 years of experience
practicing ophthalmology.
All four physicians of the Bochner Eye Institute are
involved in writing and research, and give lectures on
ophthalmic conditions worldwide. They have authored
and co-authored over 35 textbooks in ophthalmology.
The physicians have also presided over a number of
professional ophthalmological organizations throughout
their careers and are regularly called on to give seminars at clinics and conferences around the globe. They
have made extensive academic contributions to leading
medical journals and have contributed to or written
textbooks that are used worldwide in several languages.
Active hospital appointments among the group include
Mount Sinai Hospital, Scarborough Hospital, Centenary
18
AOE • Academy of Ophthalmic Education
Hospital, and Sunnybrook Hospital.
Patients of the Bochner Eye Institute come from a
wide geographic area, and span all ages, ethnicities,
and economic backgrounds. The Institute is unique in
that it also features a licensed surgical facility funded by
the Government of Ontario. It has sterile operating
rooms and a viewing area for visiting physicians, ophthalmologists, students, patients, relatives, and prospective patients, where they may watch procedures such as
cataracts and laser surgery. This was the first licensed
surgi-centre in Ontario. Visiting foreign doctors,
medical students, optometry students, and high school
students are welcomed on a daily basis as observers.
Since 1991, The Bochner Eye Institute has been on
the cutting edge of excimer laser correction for myopia
and astigmatism. Its physicians were trained by Dr.
Stephen Trokel - the inventor of the excimer laser - in
1991, and the laser’s use remains one of the pioneering
central activities of the Bochner Eye Institute. (The laser
was only approved in 1991 in Canada and in late 1995
in the United States.) In addition to mastering the
newest laser procedures available, the Institute’s ophthalmologists are eagerly developing vision correction
techniques for the future. New instrumentation is constantly being added to cataract surgery, plastic surgery,
and laser surgery; research is ongoing.
At the time of this writing, the Bochner Eye Institute
was the first and only centre in Canada to offer a new
treatment called ‘corneal collagen cross-linking with
riboflavin’ (C3R) to prevent disease progression of keratoconus. The treatment involves the use of riboflavin
drops and ultraviolet light to enhance the strength of
the cornea. This innovative treatment can also be
offered to radial keratotomy patients to reduce fluctuation in their vision as well as the hyperopic shift over
time. Other treatment modalities for keratoconus are
offered at the Institute, including intracorneal rings,
phakic implants, and topographically-linked laser ablations. The goal of these new advances is to improve
upon the Institute’s already stellar record of patient
success. The Bochner Eye Institute has become one of
the most modern, sophisticated, and patient-oriented
eye care centres in the eye care world.
Corresponding author:
Y. Ali Khan, RO
[email protected]
The Bochner Eye Institute: Part III
Y. Ali Khan, RO
D
uring their ophthalmology
training at the prestigious
Mayo Clinic and the
University of Toronto, 4 doctors
(H. Stein, A. Cheskes, R. Stein,
J. Cheskes) learned the importance
of valuing teamwork, respecting
their patients, and the beneficial role
of continuing medical education.
The Bochner Eye Institute in
Dr. Harold Stein
Toronto is based on these ideals,
which were an integral part of Dr. Bochner’s vision for
the institute. The fact that two father and son teams
work there together, make its legacy unique; all four
still teach at the University of Toronto. The doctors
agree that their greatest commendation comes from
other doctors all over the world, who refer their family
members and patients to the Institute, and who come to
study and observe the team’s surgical techniques.
The doctors are all active and
contributing members in their own
communities and in communities
around the world. They have each
traveled to developing countries to
provide clinical and surgical skills
to impoverished people, performing
procedures that improve lives
dramatically. Phacoemulsification
machines and hand-pieces have
Dr. Albert Cheskes
also been donated to surgeons in
Nicaragua, Greneda, and Nigeria in the name of the
institute.
The Bochner Eye Institute is a patient-friendly venue.
Through the work of its ophthalmologists and staff, the
institute has helped people pursue careers in policing,
firefighting, the military, and countless other professions
that are sight-dependent. To date, over 300 eye-doctors
and over 100,000 patients have chosen The Bochner Eye
Institute for their laser surgery. In fact, patients from over
40 countries have traveled to the institute for surgery.
Despite their busy practices, the
surgeons continue to write scientific
papers and lecture to the international ophthalmic community. Each
has also provided professional leadership as the president or chair of
numerous societies and committees
in Canada and internationally.
What makes the Bochner Eye
Institute so noteworthy? Quite
Dr. Raymond Stein
simply, its incredible surgeons and
its staff, who all have a tremendous commitment to the
Bochner tradition of group medical practice. Their
relentless pursuit of an effective treatment plan for
every patient makes Bochner one of the most trusted
medical and surgical centres in Canada.
Below is a timeline of the Bochner Eye Institute:
1929
Dr. Maxwell Bochner became the first trained
ophthalmologist in Canada after graduating
from the University of Pennsylvania. At that
time, the specialty included eyes, ears, nose,
and throat.
1936
Dr. Bochner became Chief of Staff at Mount Sinai
Hospital, a position he retained for 40 years.
1954
Dr. Bochner became the founder of
Scarborough General Hospital and its Chief of
Staff. He was the first and only physician in
Canada to act as Chief of Staff at two major
hospitals.
1957
Dr. Harold Stein graduated from the prestigious
Mayo Clinic with a Master’s degree and
completed a fellowship in Oxford, England.
1966
Dr. Albert Cheskes graduated from the Mayo
Clinic with a Master’s degree in clinical
research.
1967
Dr. Bochner was honored by the Mayor of
Toronto for his academic, humanitarian, and
community achievements.
1972
The first Ophthalmic Assistants’ textbook was
published. Eight further editions would be
written and distributed worldwide.
1986
Dr. Raymond Stein, the grandson of Dr.
Bochner, graduated from the Mayo Clinic and
then completed a cornea fellowship at the
Will’s Eye Hospital in Philadelphia.
1987
Dr. Harold Stein became the President of the
Canadian Society of Ophthalmologists.
1988
Dr. Albert Cheskes became Chairman of the
Eye Safety Committee of the Canadian Society
of Ophthalmologists. The Society recognized
his efforts in the prevention of sports-related
injuries.
1989
The Government of Ontario and the College
of Physicians and Surgeons designated the
Bochner Eye Institute the first and only
approved Cataract Surgical Centre outside a
hospital in Ontario.
1991
One of the first Laser Vision Correction Centre’s
in North America was opened - the Bochner
Eye Institute - and its doctors were trained by
Dr. Steven Trokel, the inventor of the excimer
laser.
AOE • Academy of Ophthalmic Education
7
OPHTHALMOLOGY
O R I G I N A L PA P E R
OPHTHALMOLOGY
O R I G I N A L PA P E R
1993
1996
1998
1998
1999
2001
2002
2002
2004
2004
2005
8
Institute surgeons wrote the first clinical textbook on Laser Vision Correction for training
ophthalmologists. The book was sold in North
America and internationally; a second edition
was subsequently written. Courses were held at
the Bochner Eye Institute for the next 13 years,
teaching visiting surgeons the latest innovative
and proven techniques.
Institute surgeons wrote Laser Vision
Correction: A New Age, which was launched at
Indigo in Toronto.
2006
The first phakic implant procedure in Ontario
was performed at the institute, for extreme
glass prescriptions that are not correctable with
laser vision correction.
The institute became the first centre in Canada
to insert intra-corneal rings to flatten the cornea
and correct nearsightedness. Dr. Raymond Stein
was interviewed on national television programs including, ‘Canada AM,’ to discuss this
innovative procedure.
The institute was the winner of the Consumer
Choice Award for the Top Laser Centre in
Toronto (9 consecutive years).
The institute was designated the Official
Laser Centre for the Toronto Maple Leafs and
Raptors, a position the Bochner Institute retains
to this date.
Dr. Jordan Cheskes joined the practice after
completing a residency at the Mayo Clinic and
then a retinal and vitreous fellowship.
The institute acquired the VISX S4 Excimer
laser from California for custom ablations.
The institute then acquired the Allegretto Wave
excimer laser from Germany for wavefront and
topography-linked laser ablations.
Dr. Raymond Stein became the President of the
Canadian Society of Cataract & Refractive
Surgery.
Canada’s first Restor multifocal implant
following cataract surgery was inserted at the
institute; it provided both distance and near
vision.
The Bochner Eye Institute was designated the
official laser and eye centre for the Toronto
Blue Jays.
A new surgical technique was pioneered by
Bochner surgeons- the Epi-LASIK without an
epithelial flap. Earlier techniques developed at
the institute include epithelial removal techniques, bitoric ablations for mixed astigmatism,
and the Stein implant.
2006
AOE • Academy of Ophthalmic Education
2006
2007
2008
The institute made news with the first 60 KHz
Intralase in Canada for the creation of bladeless
LASIK flaps.
A medical mission to Nicaragua was conducted
to train local ophthalmologists and donate surgical equipment. It was the latest mission in a
series of expeditions by Bochner surgeons over
30 years. Peru, Haiti, Malta, Cyprus, Pakistan,
as well as several African countries have also
benefited from medical expeditions by the
Bochner Institute.
The 4th edition of the textbook, Ocular
Emergencies was published. It was the 35th
book written by Bochner Institute surgeons, the
largest number of academic books written by a
private institute in North America.
The Bochner Eye Institute became the Official
Laser Centre for the Toronto FC Soccer Team.
To date, over 300 eye doctors and 100,000
patients have chosen the Bochner Eye Institute
for their laser surgery. Patients have traveled
from over 40 countries to undergo surgery at
the institute.
The institute was the first in Canada to
implant the Tetraflex accommodative implant
which provides both distance and near vision.
The institute acquired the Allegretto 400 KHz
blue-line laser, one of the fastest and most
accurate lasers in the world.
The institute was the first in Canada to introduce Corneal Collagen Cross-Linking to arrest
the progression of Keratoconus.
The institute published a book on Laser
Vision Correction (2nd Edition) to educate
consumers.
The Bochner Eye Institute celebrated its
80th anniversary.
We hope you enjoyed this brief series on the history
of the Bochner Eye Institute, and we welcome your
feedback, including personal accounts of your experience with the institute, or its ophthalmologists.
Corresponding author:
Y. Ali Khan, RO
[email protected]