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GLG News by this Author

Results of Rheopheresis for Macular Degeneration not Impressive

April 3, 2006

Analysis of:Rheopheresis for age-related macular degeneration: clinical results and putative mechanism of action | pubs.nrc-cnrc.gc.ca

For several years, TLC laser centers have been trying to expand their offerings to patients from simple refractive surgery (LASIK, PRK) to other, non-corneal procedures and they have tried to introduce rheopheresis, a new technique for treating dry macular degeneration. Given the new novel methods for treating wet macular degeneration that have received worldwide attention (Macugen, Lucentis, etc) and actually treat the cause of the problems (new blood vessel growth and leakage) and the less than spectacular results of rheopheresis and the extremely high cost of the treatments, it does not appear that this will be a likely widely accepted or successful method to treat macular degeneration in the near future. The future of the treatment of macular degeneration continues to point to the anti neogenesis medcines such a Macugen, Lucentis and other similar compounds, since they can be administered by any retinal specialists, unlike rheopheresis that would be limited to only uniquely established centers. Rheopheresis will not likely be a profitable endeavor for TLC and has not had much suceess to date.

Early Results with a New Refractive Technique that will Challenge LASIK

April 3, 2006

Analysis of:Epi-LASIK: preliminary clinical results of an alternative surface ablation procedure. | www.sciencedirect.com

Epi-lasik continues to grow as a viable and possibly safer alternative to LASIK, with excellent results and very satisfied patients. This could have a negative impact on future sales of traditional blade (eg Hansatome) and laser microkeratomes (eg Intralase, Femtec), and aid the further sales growth of epi-lasik devices made by such companies as Advanced Refractive Technologies, Norwood, Moria, and the AMO device Amadeus II.

Presbyopia Correcting IOLS will Pique Patients Interest

April 3, 2006

Analysis of:Presbyopia Correcting IOLS will Pique Patients Interest | www.eyeworld.org

Presbyopic intraocular lenses (AMO's Rezoom, Alcon's Restor, Eyeonics' Crystalens) hold the promise to correct both distance and near vision in an aging, active population, and despite the significant out of pocket cost to a patient, and the possibility of post procedure glare or haloes, many patients are extremely interested in having the procedure. Surgeons are also excited by these lenses as they can provide another source of revenue that did not exist before. Given the cost and the small but real complications associated with these IOLS, I suspect that in the next few years that its use will be only 3 to 10% of all cataract surgeries and then may possibly grow further. More advanced methods of correcting presbyopia, that are not yet FDA approved, may show promise of providing better vision, so it will have to be seen how widespread the use of the current generation of prebyopic IOLS will continue before they are surpassed.

Incidence of Major Eye Infections after Cataract Surgery - Implications for Future of Lens Based Ref

April 3, 2006

Analysis of:Incidence of Major Eye Infections after Cataract Surgery - Implications for Future of Lens Based Ref | www.ophsource.org

This study has implications on how surgeons recommend elective refractive lens based intraocular surgery, as patients will be exposed to a potentially greater risk of a devastating complication compared to having lasik or another laser based surface procedure. It has been documented that one of the greatest reasons that patients are resistant to having elective refractive procedures performed on them is the fear of a devastating, sight threatening complication. To appropriately inform a patient during the consent process, this has to be discussed and in the process may scare off many people from choosing elective lens based procedures in the future. It is not likely to affect or scare off routine cataract patients as they often are not paying for the procedure out of pocket and also have true pathology that already limits their vision.

Intralase Growth in LASIK Market will Grow Slower: Experts Divided on the Benfits

April 3, 2006

Analysis of:Experts Divided on the Benefits of Intralase | www.escrs.org

It is clear from this article that the use of Intralase has its pros and cons and that it is an expensive device that only a practice with high enough lasik volume can afford to have (as the greater patient volume and average extra $500 per eye can help pay for the device). Given that most high volume practioners have already purchased or have access to an Intralase device currently (often fueled by advertising, patient preference and economic pressures), it is not likely that Intralsae will continue to show such growth of it sales as it did from 2002 to 2005. There has been a growing trend in the last two years towards performing more advanced surface ablations procedures where a flap is not created at all (such as LASEK, epi-lasik or PRK). The belief is that any type of flap can induce certain optical aberrations that with our more modern lasers, can often be avoided by not creating a flap in the first place. Given that there are thousands of perfectly functioning and efficient blade microkeratomes (that should continue to be useable for several more years before they must be replaced) and the continued high cost of the Intralase, it will likely mean it may take several more years before Intralase can achieve 40% of all LASIK procedures in the USA. In regards to other parts of the world where Intralase wants to expand it sales, namely Asia and Europe, they are likely to see even slower growth as lasik volumes per surgeon there tend to be significantly lower than in the USA, and Europe, in particular, is a much less ‘advertising driven’ market compared to the USA. In the meantime, if the other FDA approved femtosecond laser flap creator, the FEMTEC device by Perfect Vision 2010 GmBH, or another competitor with a cheaper price emerges, it could further stunt Intralase’s growth in the USA in the upcoming years.

FDA Warning Letter Issued to Alcon’s Excimer Eye Laser System (LADARVISION)

April 3, 2006

Analysis of:FDA Warning Letter Issued to Alcon’s Excimer Eye Laser System | www.fda.gov

Alcon has had several serious issues with its laser system brought to its attention by an FDA warning letter and it needs to rectify these quickly to maintain surgeon and patient satisfaction in the highly competitive and unforgiving practice of LASIK.

Pfizer's Anti Glaucoma Eye Drop (Xalatan/Latanaprost) Continues to Dominate Field

April 3, 2006

Analysis of:Comparison of the Effects of Latanoprost, Travoprost, and Bimatoprost on Circadian Intraocular Press | www.sciencedirect.com

Pfizer's Xalatan (latanaprost) is the number one prescribed eye pressure lowering eye drop (for glaucoma) and has a ten year track record of effectiveness and safety. Since several years Alcon and Allergan have tried to attack this dominance by introducing their own version of a prostaglandin analogue eye drop for lowering pressure..While several studies sponsored by their respective drug manufacturers tried to point out the benefits of Travaprost and Brimataprost over Xalatan (Latanaprost), nothing was extremely significant. Given that millions of patients already use Xalatan and are very satisfied, and given that a physician is not likely to switch to another eye drop that does not appear to produce any added benefit, this study supports Xalatan (Latanaprost) continuing to be the dominant IOP lowering eye drop for the foreseeable future. Again, while they are all apparently just as effective, the several years head start in being on the market, has given xalatan a huge benefit and share of the market. Also, while xalatan (Latanaprost) appears on almost all insurance companies drug formularies, the same cannot be said for Travaprost and Bimatoprost. While Allergan and alcon have other successful anti glaucoma eye drops, it appears that Pfizer's dominance in the field of prostaglandin will still secure.

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