BY JEREMY PEPPAS

Dr. Mike McFarland has heard the criticism.

Way back in 1989, it started.

"I can remember the patient and the time," he said. "That was 1989, December of 1989."

That was when McFarland told his surgical crew that he was going to perform cataract surgery, but he wasn't going to use a suture.

"At the time we were doing small-incision surgery," he said. "And we had been putting in a single, horizontal suture. I had been doing those and those were working just fine. I began to notice in the operating room that if I fashioned the wound a certain way, with certain planes to the wound and created an internal lip for the wound, that the wound was watertight and oftentimes after putting the suture in and tightening it, that would start to leak. So it was watertight until you put the suture in."

It seems simple enough now, but what McFarland had figured out that was that "if you put enough surface tension that the area would be watertight."

By this point, the Hot Springs-born McFarland had already established a large ophthalmology clinic in Pine Bluff and was doing a number of no-stitch surgeries.

He felt confident enough in what he was doing to prepare an article for an ophthalmology journal in January 1990.

"When that hit the press, that hit the fan," McFarland said. "I had people calling me from all over the world telling me that it was impossible for it to be watertight without any sutures and that I must be an idiot down there in Arkansas."

It wasn't just that. "I heard everything. Every top person in ophthalmology was calling me and telling me how big of an idiot I must be and how all these eyes were going to go blind and that they would all leak and this, that and the other."

But McFarland stood tall and he had the surgical experience to back him up. "At that point I had done five or six hundred and I was pretty confident."

Confident to the point where he began speaking at ophthalmology gatherings around the country, he even performed live surgeries as hundreds of other ophthalmologists watched.

They still didn't believe what their eyes were telling them.

"They just didn't believe that it was possible," he said. "That it must be some kind of a sham. They accused me of faking the videos and that it just didn't make sense to them. … I got cut into small pieces and just got called everything in the world."

McFarland took comfort from some of what was said.

"This one guy said something to the effect of 'Could anything good come out of Arkansas?' It kinda reminded me of Scripture, 'Can anything good come from Nazareth?' and I was like, thanks. I was going to take it as a kind of back-handed compliment that you aren't even aware of."

But not all were insults, and it was when Dr. Jim Gills decided it was his turn to say something that the tide began to turn.

Gills, of Tarpon Springs, Fla., is a Duke University Medical Center graduate and has authored seven medical textbooks.

"When he got up, everybody listened to what he had to say," McFarland said. "He said, 'I think this is the future of ophthalmology. I think this is for real.' And when he said that, a lot of people went, 'Hmm.'"

After graduating from Lakeside High near Hot Springs and from Hendrix College, McFarland went to medical school at UAMS and then off to a residency at LSU-Shreveport.

Ophthalmology wasn't his goal then.

"I was at LSU and with the intent of doing ob/gyn," he said. "I had just been up night and day for months and months. ... I ran into a friend of mine from Arkansas, his name is Joe Stainton, he's up in Jonesboro, and he's a great guy. I had a month of elective and he said 'why don't you take your month of elective and come up and do ophthalmology?'"

McFarland wasn't interested, but then Stainton dropped the bomb.

"He said there's no call," McFarland said. "And I said, what do you mean, no call? And he said, 'no call means that you can be home at 5 o'clock every day.'"

It was then when McFarland decided to pursue ophthalmology.

While getting to sleep at night was the draw, that wasn't what kept him there.

"I just fell in love with the concept of microscopic surgery, doing the surgery under a microscope," he said. "It is, to this day, the most fascinating surgery in all of medicine."

McFarland was so convinced after his time under the 'scope, he added, "I went home and told my wife that I have found what I want to do for the rest of my life. This is it, this is the most exciting thing."

Turned out it was a pretty good choice.

"I think I've done about 60,000 cataract surgeries," he said. "I see about 20,000 [patients] a year and I do about 100 procedures a week."

This year will be the 26th year in practice for McFarland, who now has three clinics and about 54 employees. The first clinic was in Pine Bluff, followed by Hot Springs and the newest one is in Little Rock.

"I also have two surgery centers, one here [Little Rock] and one in Pine Bluff," he said. "The majority of our business is in Pine Bluff, but Little Rock is catching up quickly to that."