I. Howard Fine, MD, esteemed ophthalmologist, dies

Richard L. Lindstrom, MD

I. Howard Fine, MD, played an important role in my ophthalmology journey and life. I met Howard early in my career, and he befriended me immediately, as he had hundreds of other young anterior segment surgeons around the world thirsting to learn from this grand master cataract/IOL surgeon.

At first, Howard was a much-appreciated teacher and mentor. Then, as my career evolved, we traveled the world together for decades teaching cataract and refractive cataract surgical skills. Howard founded a patient-centered ophthalmology practice in Eugene, Oregon, with shared technician services and an ambulatory surgical center that served as a model for many practices. The ophthalmology practice he founded continues to prosper and is now led by Richard Hoffman, MD, also a past president of ASCRS.

Howard dedicated himself to leadership at ASCRS and served as its president. His practice and only two others have generated two presidents of ASCRS. Howard led the creation of the ASCRS Foundation, and he nurtured it through its formative years as the first ASCRS Foundation board chairman.
Howard, along with his wife, Vicky, were full of life and great fun. We rode motorcycles together, shared great meals, good wines and a few cigars, and our wives became close friends.

Howard Fine will be remembered by his patients as a compassionate, caring physician and master surgeon. He will be remembered by his colleagues for his friendly welcoming nature, commitment to teaching others and extraordinary contributions to ASCRS. I will remember him for his love of life and the great friendship we shared.

Stephen S. Lane, MD

Howard Fine was a giant — not only in ophthalmology but also in life. From the private practice that he started in Eugene, Oregon, as a comprehensive ophthalmologist performing not only cataract surgery but retinal buckles and strabismus procedures, Howie began to concentrate on phacoemulsification and IOLs as they were newly developing. In his capacity as a researcher, Howie contributed significantly to the academic and clinical communities producing work that led to innovations in both theory and practice. His research was characterized by a relentless pursuit of new intuitions, always with an eye toward practical application and improvement in patient care. His insights on ultrasound power modulation, astigmatic neutral incision closure and small-incision cataract surgery are only a few of Howie’s contributions.

Howie personally touched the lives of a generation of ophthalmic surgeons across the globe because of his innovation, creativity, humanity and most importantly as a teacher and educator. His impact was felt not only through his technical skills but also through his dedication to advancing his field, always pushing the boundaries of knowledge and practice. This led to his extensive travels around the world to educate colleagues. Soon, he became as well known and adored in South America — especially Brazil — Europe and Asia as he was in his beloved Eugene community.

His accolades are highlighted by his presidencies of the American Society of Cataract and Refractive Surgery and the International Intra-Ocular Implant Club. He received the ASCRS Innovator’s and Binkhorst Medals, as well as the AAO’s Kelman medal. In 1999, he was named one of the 25 most influential ophthalmologists of the 20th century, and in 2018, he was inducted into the ASCRS Hall of Fame.

It was against this backdrop that Howie took the time to patiently explain one of his recent innovations, the infinity suture for small-incision cataract surgery, to a recently graduated corneal fellow just starting clinical practice. That new graduate was me, and from that moment, a lasting friendship and bond were formed. This was the essence of Howie Fine and, to me, his legacy. He influenced countless students and professionals, guiding them to not only master their craft but also to approach their work with the same curiosity and rigor that defined his own career. His teaching was not just about transmitting information but rather about inspiring a deep enduring love for learning and a commitment to excellence. Whether an experienced surgeon or a neophyte, Howie made time for you — always with a keen wit, enthusiasm, a smile on his face and jokes to keep everyone in the room loose. He worked to make everyone better. This was his passion and brilliance.

Standing beside Howie for all his professional and nonprofessional life was his wife, Vicky, who was a steadfast support behind the scenes. Howie frequently made it known that marrying Vicky was the best decision he ever made in his life. Her presence was a critical part of Howie’s journey, providing the balance that enabled him to excel in all his endeavors. Together, they embodied a partnership built on love, mutual respect and shared purpose. Howie made the world a better place for everyone and will be greatly missed.

Richard S. Hoffman, MD

With the passing of I. Howard Fine on Aug. 29, ophthalmology has lost one of its most innovative and prolific surgeons. I had the pleasure of working with Howard for more than 30 years and was always impressed with his work ethic, ingenuity and approachability. Howard was instrumental in improving the power modulation settings that we currently take for granted on our phacoemulsification machines. He described cortical cleaving hydrodissection for improved cortex removal, and most importantly, he was the innovator of clear corneal cataract incisions.

Many younger surgeons are probably not aware that phacoemulsification was originally performed through a superiorly located scleral incision with or without the use of sutured wound closure. Howard discovered that the surgery could be performed through a small temporal clear corneal incision, imparting many benefits such as a reduction in against-the-rule astigmatism drift. Clear corneal cataract surgery is now the norm throughout most of the world thanks to Howard’s innovation.

Howard was a caring, ethical, hardworking surgeon who was loved by his staff, patients and fellow ophthalmologists around the world. He had a tremendous wit and enjoyed teaching surgeons to perform better cataract surgery.

Howard was one of my best friends, and I will miss him dearly.