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13 EW NEWS & OPINION by David F. Chang, MD through a well-capitalized enter- prise. The same has been true with microstent technology for glaucoma where my team at Transcend has been working for nearly 10 years on bringing breakthrough innovation into this space. So, after these expe- riences with product development in biopharma and medtech, entering the world of venture capital was a logical next step. Venture finance requires not only financial expertise, but also a true understanding of product development, science, and clinical utility. Dr. Cunningham: I was first exposed to VC while working at Eyetech, a Dr. Chang: Tell us about why, how, and at what point in your career you decided to go into venture capital. Dr. Kliman: Coming from a non- business family of scientists and doctors, I never considered a busi- ness career. But as a retina fellow at Mass Eye and Ear in Boston, I started working with ophthalmic laser companies through my research studies, and I became fascinated with innovation and startup com- panies. I was able to join a large venture capital group, TA Associates, right after fellowship, which also allowed me to practice part time, so I could experience the business and medical worlds simultaneously. I really liked the new horizons of business but felt like I was doing surgery without knowing the anat- omy. Therefore, I went to Stanford Business School to get my MBA and got 100% converted to the dark side doing venture capital in Silicon Valley. I have been a partner at InterWest Partners for the last 18 years, investing mostly in oph- thalmic devices such as IntraLase (Abbott Medical Optics, Santa Ana, Calif.), LenSx (Alcon, Fort Worth, Texas), and those from Glaukos (Laguna Hills, Calif.) and ReVision Optics (Lake Forest, Calif.). Dr. Ianchulev: As someone who loves ophthalmology and clini- cal care, mine was definitely not a straight path into the world of venture finance. It started with my unanticipated detour into the world of innovation. Right after residency at Doheny Eye Institute, as I was contemplating a career in academia, I ended up initiating two research projects, which turned into inventions. One of these became a fully commercialized technology backed by close to $100M of venture capital investment to date—namely WaveTec Vision and intraoperative aberrometry. Seeing what it took to develop a breakthrough product, with more than 10 years of R&D, it became apparent to me that the path to innovation goes through the commercial side even though it may start in academia. This was further reaffirmed by my work at Genentech where I headed the Lucentis development programs. There, we built something special that could only have been achieved Ophthalmologists in venture capital I am fortunate to live and practice in Silicon Valley, where many friends, neighbors, and patients are involved with startup companies and high-tech innovation. Silicon Valley is also a haven for physicians interested in biomedical clinical trials and research, and this is certainly true for ophthalmology. Venture capital (VC) fuels this innovation, and Sand Hill Road in nearby Menlo Park is the mecca of the VC world. Most VC firms investing in biotechnology have full-time physician partners, who have often left traditional academic or private practices to concentrate on identifying, investing in, and bringing promising startup technologies to market. This month, I interviewed 3 ophthalmologists who are partners in prominent Silicon Valley VC firms. Like me, you may be struck by the unconventional career path that they each took—choosing to pursue and advance medical device innovation largely from the business side rather than through full-time basic or clinical research. Gil Kliman, MD, graduated from the University of Pennsylvania School of Medicine. He completed his residency at Wills and his retina fellowship at Massachusetts Eye & Ear Infirmary (MEEI), prior to joining the Tufts full-time faculty and the MEEI clinical faculty. After working as a healthcare investor at TA Associates, he earned his MBA from Stanford Business School. He has been a partner with the healthcare team of InterWest Partners (Menlo Park, Calif.) since 1996. Sean Ianchulev, MD, received his MD and MPH from Harvard, and completed his ophthalmology specialty training at USC/Doheny. He is currently a venture partner at Tullis Health Investors and a managing director of Private Medical Equity Inc., a private equity firm for managed direct investments in healthcare. Earlier, Dr. Ianchulev headed the biotech ophthalmology group at Genentech (South San Francisco) and was instrumental in the design and launch of the Lucentis clinical programs. He is the technology founder and inventor of intraoperative aberrometry (WaveTec Vision, Aliso Viejo, Calif.) and currently serves as the chief medical officer of Transcend Medical (Menlo Park, Calif.). Dr. Ianchulev is an associate clinical professor at UCSF and his academic work has been cited by more than 2,000 peer- reviewed publications. Emmett Cunningham, MD, received his MD and MPH from Johns Hopkins and his PhD from UCSD. Following his UCSF residency and fellowships at Proctor (cornea/uveitis) and Moorfields (uveitis/medical retina), he served as uveitis director first at UCSF and then at NYU before joining Clarus Ventures in 2006, where he is now a full partner. Dr. Cunningham founded the Ophthalmology Innovation Summit (OIS), which is an interdisciplinary 1-day symposium for clinicians, researchers, investors, and companies held immediately prior to the AAO and ASCRS annual meetings. David F. Chang, MD, chief medical editor Chief medical editor's corner of the world Gil Kliman, MD Emmett Cunningham, MD Sean Ianchulev, MD continued on page 14 November 2014