Eyeworld

NOV 2014

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

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EW NEWS & OPINION 16 November 2014 with related huge financial success- es. We need to highlight the suc- cessful medical companies, devices, biotech, and healthcare IT alike to reinforce the message that medical innovation is worth pursuing and provides huge value to all constitu- ents: patients, doctors, and financial institutions funding innovation. Investing in medical innovation has a unique value proposition of producing enormous societal and financial benefits at the same time. We need to get more press cover- age and broad societal appreciation of disruptive breakthrough tech- nologies like MIGS for glaucoma treatment and femtosecond lasers for anterior segment surgery, and counterbalance the distraction of less meaningful but more popular innovations in consumer technolo- gy such as mobile phone apps and cloud computing. A lofty goal would be to get college students creating medical startups in their dorm rooms rather than chasing the next Facebook or Twitter. Dr. Ianchulev: It is very simple and along the lines of what has been his- torically successful in the U.S. Invest in academia and early research, and break down the barriers to tech- nology transfer to the private side. Finally, make the regulatory system more nimble, less defensive, and more collaborative. The "pull" for innovation is there, by both patients and physicians, who have a height- ened sense of clinical value and are becoming savvier consumers. With the new reality of healthcare, the focus is less on "me too" innovation and more on efficiency, value-add and evidence-based utility. And everybody realizes this. Dr. Cunningham: There are no quick fixes. The best thing would be for society to maintain its commitment to technical education and govern- ment-funded research through the NIH. As the population ages and the tax base decreases, funding innova- tion will become harder, not easier. The great hope is that we somehow figure out how to make the drug/ device development pathway cheaper and faster. While I am op- timistic that advances will occur in this regard, I can't tell you when or how. EW Contact information Cunningham: ECunningham@clarusventures.com Ianchulev: tianchul@yahoo.com Kliman: gkliman@interwest.com and devices through development. The FDA could be more efficient and helpful, but as big government agencies go, it's not bad. Dr. Chang: Despite leading the world in so many other areas of technology, are we in danger of losing our prominence in medical device and pharmaceutical innovation? Dr. Kliman: The rest of the world is slowly closing the gap, but the U.S. has a unique environment of culture and resources that still make it the best place in the world to innovate. There are many countries that can do well in adoption of new technol- ogies, but very few that can success- fully innovate and iterate to create breakthrough new products. Just as Silicon Valley remains the world engine of internet-based innovation, the U.S. as a whole remains the global king of medical innovation. As long as we can continue to cultivate our native talent as well as attract the best medical minds from around the world to come here to the U.S., I believe our leadership status is unassailable. Of course, we must provide the venture capital resources to fund their ideas and bring innovations to market. Dr. Ianchulev: I think we are near- ing a crucial juncture in medical technology—a fusion point between genetic information, regenerative medicine, and gene therapy. We can either lead this revolution or play second fiddle. Globally, many coun- tries such as China, Singapore, and countries in the EU are investing heavily in biotechnology and med- tech. At the same time, U.S. venture capital and government research funding are shrinking—$27Bn in 2013 vs. close to $100Bn in 2000 of venture dollars invested according to the PWC/NVCA statistics. But I am less worried about the capital side of the equation, since money changes direction frequently and easily. The real danger is when people, talent, and know-how follow—we cannot afford such expatriation. Dr. Cunningham: I don't believe so. By far, most drug and device inno- vation is still done in the U.S. Of course, important innovations occur in Europe, Israel, and Japan as well, but as a proportion of the whole, the U.S. contributions far exceed those of other countries. I think it would be a great thing for other countries, particularly China and India, to become more innovative when it comes to the development of drugs and devices. Rising tides, as they say, raise all boats. Dr. Chang: What can be done to sustain and improve medical innovation in the U.S.? Dr. Kliman: We need to continue to invest in the infrastructure for inno- vation, which includes education, platforms for product development like incubators, and win-win intel- lectual property deals for spinning out university-based technology. We also need capital to fund these projects and reverse the trend in which financial markets have be- come unfairly bearish on medical investing. While there have been challenges and failures due to regu- latory hurdles and reimbursement changes, we still live in an era of unprecedented medical innovation TORIC/LRI MARKERS S9-2033 Pre-Operative Alignment Marker For marking patient on gurney or at slit lamp prior to procedure • Three fine marking points at 3, 6 and 9 for accurate reference • Properly angled handle allows an unimposing approach to patient S9-2060 Mendez Style Degree Gauge Intra-operative ring for aligning to steep axis and defining LRI points • Large 11.7mm internal diameter provides for maximum visualization • Beveled surface reduces reflections form microscope lighting • Crisp laser etched markings every 5˚ for greater marking accuracy S9-2065 Axis Marker Works inside the Degree Gauge to mark prime meridian (steep axis) for LRIs and Toric alignment. • Fits inside Degree Gauge perfectly • Crisp edges create a fine demarcation • Length of marks accommodates both limbal and corneal marking S9-2050 LRI Marker Provides crisp marks at commonly used LRI Positions • Fits inside Degree Gauge perfectly • Creates symmetrical, opposing marks for 30˚, 45˚ and 60˚ incisions • Fine arc connects degree endpoints for easy, acurate incisions 2500 Sandersville Rd., Lexington, KY 40511 USA Phone: 800-354-7848, 859-259-4924 Fax: 859-259-4926 E-Mail: sales@stephensinst.com www.stephensinst.com Ophthalmologists in venture capital continued from page 14

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