Eyeworld

by Matt Young EyeWorld Contributing Editor Global ingenuity often trumps the American type Acting locally, international ophthalmologists spur on innovation T he United States has long been regarded as a mecca of innovation—a notion that is believable in the field of ophthalmology. But just a couple of phone calls to interna- tional ophthalmologists suggest that much innovation in ophthalmology occurs well outside of U.S. borders and often for good local reasons. EyeWorld chose two ophthal- mologists to speak with from the International Intra-Ocular Implant Club (IIIC). Although part of the mission of the IIIC is to promote IOL implantation research, as well as cultivate an exchange of ideas re- lated to IOL implantation, there is something especially impressive about the advancement of oph- thalmic innovation, thanks to mem- bers of this group. With love of research, from Russia Boris Malyugin, M.D., Ph.D., chief, cataract and implant surgery depart- ment, and deputy director general, S.N. Fyodorov Eye Microsurgery Complex State Institution, Moscow, is from a medical family, and there was really no choice for him other than to become a doctor. But from this monotonous fam- ily history, Dr. Malyugin, an IIIC member, became a Russian oph- thalmic innovator—something that he explains is not exceedingly unique among Russians. "Russian companies are very good at producing, but not many are very good in marketing," Dr. Malyugin said. "We are good at de- signing, but in sales we have to col- laborate with other companies that are good at this." Dr. Malyugin is a case in point. The Malyugin Ring (MicroSurgical Technology, MST, Redmond, Wash.) is Dr. Malyugin's invention. "The idea for this product came from complications," Dr. Malyugin said. "Not complications like floppy iris, but from the lens." A locally manufactured lens was causing problems at the time, but it gave Dr. Malyugin an idea. "In Russia for a long time we used one lens manufactured locally," Dr. Malyugin said. "It had two hapti- cal elements in the form of loops— loops that look very similar to loops in the corners of the Malyugin Ring today. [Back then] I occasionally caught the iris or capsule with this [IOL] loop. It was an unwanted situ- ation. After that, the idea came to me to create a good thing from this problem—to use this method to stretch the iris." The Malyugin Ring was born to catch and retain the pupillary mar- gin—something that became partic- ularly useful later in the era of intraoperative floppy iris syndrome (IFIS). Dr. Malyugin calls the product "innovation from Russia," which had some help from MST, a com- pany focused on marketing innova- tion and quality, he said. This type of story repeats itself often in Russia. In the 1980s, a lo- cally manufactured Russian lens was tinted yellow, Dr. Malyugin said. "It was the first yellow-tinted lens in the world," Dr. Malyugin said. "It was sold in ex-Soviet Union re- publics and was a popular lens. Ten years later, Alcon [Fort Worth, Texas] came up with the AcrySof Natural, which was the first yellow-tinted flexible IOL." It makes you wonder—what might be coming out of Russia next? "We are now working on a proj- ect involving a very interesting mul- tifocal lens," Dr. Malyugin said. "Splitting the light that comes EW International August 2011 29 Y ou never know where the next big idea is going to come from. Ophthalmologists from around the world face similar challenges, but each region has unique subtleties to its training and exposure. The incubator for innovation is often as simple as applying a unique perspective to a common problem. In this month's column, Boris Malyugin, M.D., Ph.D., and Hungwon Tchah, M.D., Ph.D., describe how local circumstances led them to develop a new device to maintain pupil dilation and a new twist on clear corneal incisions. Advances in ophthalmol- ogy are a global effort that benefit us all. Who would have predicted that a patient with small pupils on Flomax (tamsulosin, Boehringer Ingelheim Pharmaceuticals, Ridgefield, Conn.) would indirectly benefit from a dodgy Russian IOL design? This is the new world we live in. In the future, watch for regular features in EyeWorld highlighting the individuals who are mak- ing a difference in our global community. John Vukich, M.D., international editor International editor's corner of the world continued on page 30 Hungwon Tchah, M.D., Ph.D. Boris Malyugin, M.D., Ph.D. 28-31 International_EW August 2011-FINAL_Layout 1 7/27/11 3:42 PM Page 29

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