Thank you for being such a good colleague and referral doctor over the years. We appreciate your confidence and we are enthusiastic about offering new and advanced therapeutic approaches to all anterior segmant eye problems. I am excited to offer these advanced techniques in my surgical practice: Descemet’s Membrane Endothelial Keratoplasty (DMEK). Descemets’ membrane is stripped from the recipient and replaced with normal Descemets membrane and endothelium, carefully harvested from the donor; only 15 microns thick! DMEK, DSAEK and Penetrating Keratoplasty are some of the surgical techniques I can offer your patients with posterior corneal dystrophies. I am happy to evaluate patients of any age, disability or with concurrent eye diseases. I have also continued to refine the Deep Anterior Lamellar Keratoplasty (DALK) in keratoconus, ectasia, corneal scars and any corneal disease process that does not involve the endothelium. During the past 12 years I have refined the “big bubble technique” to achieve excellent visual results with more normal corneal curvature and rapid visual recovery. Retaining host endothelium and descemet’s layers can minimize graft rejection for our goal: “a transplant for life”.
Some of my recent surgical cases of interest:Treating Pterygium with stem cell transplant in my office for patients with no insurance or very high insurance deductibles
Treating irregular or high astigmatism greater than 6 diopters in my office, under drop anesthesia, with relaxing corneal incisions with or without sutures
Diagnosing and treating Demodex to significantly improve blepharitis
In office lamellar kerartectomy can be the optimal (and economical) treatment for Salzmann’s nodular dystrophy and anterior membrane dystrophy
The Maskin probing procedure, with adjunctive therapy in my office procedure room for Meibomian gland disease has met with great success and high patient satisfaction.
Placement of Boston Keratoprosthesis in aniridia, chemical injuries of the eye and Cicatricial pemphigoid
Corneal stem cell deficiency
LASEK (retaining epithelium) I have found to be very effective in post-surgical anisometropia: a recent post-PK patient changed from:-11.00 +9.00 x 80 to -1.00 +2.00 x 90 or 20/ ‘ecstatically happy’!
Other interesting cases I have treated in 2015 include :
Steven’s Johnson corneal perforation with transplant and tarsorrhphy who now can read her tablet. Another Stevens-Johnson patient came to the office with a small pillow over her eyes to avoid the pain of any light. Vision was hand motion at 2 feet. She underwent corneal stem cell transplant with amniotic membrane, followed months later with penetrating keratoplasty. Uncorrected vision is now 20/40. Her life has changed completely. Keratoconus with corneal transpllant failure and a huge iris cyst. The cyst was completely excised and the iris diaphram recreated by piecing the residual iris together. The result is a functinal pupil, cosmetically pleasing and vision of 20/25 with glasses.
Calculating keratometry/topography and endothelial cell counts in patients with keratoconus, corneal dystrophy, ectasia and post – refractive surgery for more accurate IOL calculation, including tunnel scleral fixation of IOL with glued haptics
Autologous serum drops encourage epithelial and neuronal regrowth in neurotrophic kerititis, persistent epithelial defects and intractable dry eye.
Treating Alkali injury, acid injury, globe perforation and traumatic aphakia including workman’s comp cases
Biopsy diagnosis of cicitricial pemphigoid, then coordinating my anterior segment eye care with the oncology team.
Dr. Alvarez enjoys working with patients with challenging contact lens problems including keratoconus, dry eye, and cornea irregularities of all types and fitting of other unique contact lenses. She also enjoys solving difficult prism, refractive and occupational visual problems, especially post-surgical anisometropia and children with special optical needs.
It is our pleasure to be a resource for you and your difficult and challenging patients. We encourage you to call our office at 205-877-2837 or after-hours at 205-266-8888. Please visit our website at www.pfistervision.com. We have secure email and we welcome your response.
Roswell R Pfister M.D., fARVO
Past Chairman, Department of Ophthalmology, UAB
Past Chief of Ophthalmology, Eye Foundation Hospital
Clinical Professor of Ophthalmology, UAB
President and CEO, The Eye Research Foundation
Sarah L Alvarez, O.D., Ph.D
Assistant Clinical Professor
University of Alabama