Eyeworld

EW NEWS & OPINION June 2015 23 The Folden* Femto Double-Ended Dissector 3360 Scherer Drive, Suite B, St. Petersburg, FL 33716 800-637-4346 • Tel: 727-209-2244 • Fax: 727-341-8123 Email: Info@RheinMedical.com • Website: www.RheinMedical.com *Developed In Coordination With David Folden, M.D. Lamentation, Michelangelo ACBF 1360 Rev.A 8-10144 Folden Femto Double-Ended Dissector, 0.7mm & 1.2mm • Clear Corneal Incisions (CCIS): The 1.2mm End Provides Easy Entry Into Standard Small Incisions As Well As Sub-2.0mm Micro-Incisions. The 0.7mm End Provides Ample Clearance For Entry Into The Paracentesis. • Arcuate Incisions (AIS): Arcuate Incisions For Astigmatism Are Opened Quickly And Cleanly Down To Their Base Without Risk Of Perforation. The Polished Semi- Blunted Leading Tip Glides Smoothly Along The Base Of The Arcuate Incision, While The Sharp Edge Provides Smooth Opening Of Stromal Tissue Bridges And Maintains Clean Epithelial Edges. Fewer Surface Abrasions Result In Less Foreign Body Sensation And Improved Patient Comfort Postoperatively. The Folden Femto Dissector Is A Single Instrument Designed For Smooth Opening Of All Femtosecond Laser – Created Corneal Incisions During Cataract Surgery. The Double-Ended Instrument Measures 0.7mm At One End, And 1.2mm At The Other. The Polished, Semi-Blunted Leading Tip Allows For "Scoring" Of The Epithelium And Provides Easy, Glided Entry Into The Femtosecond Laser – Created Corneal Incision. The Unique Sharp Edge Design Cleanly Separates Residual Tissue Bridges And Stromal Adhesions That Provide Resistance To Entry Using Standard Instruments. Please Watch The Video Or Contact 727-209-2244 For More Information. sidebar for more details on upcom- ing drug delivery innovations). Then there is the need to deliver medications more cost effectively, said Stephen Bloch, MD, gener- al partner for Canaan Partners, Westport, Conn., and on the board of directors for Envisia, Research Triangle Park, N.C. "Pharmaceutical companies are getting the message. Selling a new drug that's $50,000 a year will be hard. You have to have the cost-benefit success to make a drug pull through," he said. That is why he thinks drugs or drug delivery systems that offer block- buster benefits, versus small incre- mental changes, will be the winners. The next 5–10 years So what will ophthalmic drug deliv- ery look like in the next 5–10 years, beyond eye drops or injections? Think long-term, less invasive, and nano-sized. There will be more drugs for conditions like AMD or glaucoma that will be offered via sustained release, Dr. Noecker thinks. "There's a lot of interest in that right now, and that will become the norm in the next 5 to 10 years," he said. This could be via punctal plug- based technology or contact lenses, among other approaches. During surgery, delivery meth- ods like dropless cataract surgery (Imprimis Pharmaceuticals, San Diego), which delivers a compound- ed mix of drugs transzonularly and remains in the eye for about a week, will also become the norm within 5 years, Dr. Noecker predicted. It is not likely that eye drops will completely go away, Dr. Noecker said. What is likely is that ophthalmologists will customize drug delivery for each patient—per- haps an injection for one patient, a punctal plug drug delivery system for another, and then the occasional drop added to the mix, he said. There will also be an emphasis on using delivery methods that are less invasive than implants and injections, said Guillaume Pfefer, PhD, president and CEO of Kala Pharmaceuticals, Waltham, Mass. Many of the newer delivery methods will focus on nanoparticles as well, he added. Michael J. O'Rourke, president of Scotia Vision Consultants, Tampa, Fla., thinks that the next generation of true posterior segment drug de- livery innovations, beyond the few already approved and on the market today, may take closer to 7–10 years to fully reach the market. Those within ophthalmology will see the large pharmaceutical leaders in the specialty partner more with small entrepreneurial companies to collab- orate on drug delivery methods, he predicted. Comparing ophthalmology to other specialties Some observers think that the ophthalmology community has remained behind other specialties in finding new drug delivery methods, at least until recently. "The last 5 years have been very good because the reasons that people go blind are now being addressed," Dr. Ashton said. "We're at a golden opportunity now, but there's still potentially a lot of im- provement." "The cutting edge for drug deliv- ery has typically been in oncology. I think that's because of genetic testing and the understanding of the diversity of cancer," Dr. Bloch said. "Ophthalmology is probably in the middle of the pack. There aren't many companies out there with ophthalmology franchises, and that might be a limitation." "We in ophthalmology think we're ahead and we usually are, but I think this is an area where we're not," Dr. Noecker said. Yet he added that ophthalmic drug delivery hasn't traveled behind other specialties due to lack of innovation—it is more about the challenges of reaching the eye effectively. He said that even de- veloping an eye drop that is safe in the eye, can reach the right area of the eye, and remain safe in a bottle is a marvel in itself. "It's a challenge to deliver a drug to the eye," Dr. Pfefer said. "The eye is an organ that's well protected." EW Contact information Ashton: bjedynak@janispr.com Bloch: carolyn@canalecomm.com Noecker: noeckerrj@gmail.com O'Rourke: scotiavc@gmail.com Pfefer: Guillaume.Pfefer@kalarx.com

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