Orange County Goes Eye Tech

By Lisa Liddane, The Orange County Register, Calif.

Mar. 30–Before he moved here in 2004, Harvard ophthalmologist Dr. Roger Steinert knew Orange County as the Mecca of eye technology and research.

What he didn’t know was his arrival, from Boston, was impeccably timed.

“Orange County has not just met, but exceeded my expectations,” said Steinert, chairman of department of ophthalmology at UC Irvine.

The eye-surgery industry is at the cusp of what could be the next big wave of vision-correction technologies to greet consumers since LASIK reinvented the eye-care business in 1995. And Steinert, president of the American Society of Cataract and Refractive Surgery (ASCRS), is in the thick of it in O.C.

Many of these innovations target presbyopia, the aging of the eye’s crystalline lens that makes reading difficult. Some improve upon previous technologies that repair cataract-clouded eyes. And others make incisions more precise or eliminate having to cut into eye tissue altogether.

“Eye patients now can be treated from cradle to grave,” said Shareef Mahdavi, president of SM2 Consulting, a Pleasanton-based company that advises ophthalmic and medical companies, including eight O.C. firms. LASIK caters to the eyes of people in their 20s to their early 40s, he explained.

Cataract treatments address the eyes of older people. Emerging treatments for presbyopia are designed for people in their mid-40s to 60s, filling the age gap.

And the potential market looks promising. About 76 million baby boomers are in, or near, their presbyopic years.

Most of the latest innovations have been incubated in Orange County, a region Mahdavi describes as “No. 1″ in the country when it comes to new eye technology.

“There’s no question that having a large concentration of ophthalmic companies makes it easier for companies to recruit talent, whether it’s in the scientific, technical, marketing or regulatory areas.” The synergy in the industry fuels innovation and entrepreneurship, said Bill Link, managing director for Versant Ventures, a Newport Beach company that supplies venture capital to health-care startups.

“Sometimes, some employees become entrepreneurs,” said Link, who has helped launched several O.C. eye-tech companies, and thus is widely regarded as the local eye-care industry’s godfather.

Strong ties to academia are vital to the industry’s growth, according to Link. “Having Beckman Laser Institute at UCI is important. But it’s even more important that UCI is beginning to focus on helping foster more technology transfer out of the university into the entrepreneurial community.” It’s no surprise, then, that UCI’s Steinert and his colleagues have access to some of the newest eye technologies for projects and studies.

Steinert, for example, is overseeing a project involving the use of the latest high-speed laser from Irvine-based IntraLase Corp. in transplanting a deceased donor’s cornea to a living eye. He uses the laser to etch markings on both the donor tissue and the recipient’s cornea, much in the same way that garment manufacturers use computerized machines to mark a pre-programmed dress pattern on fabric.

The eye technology ensures that the donor cornea fits the recipient’s eye as perfectly as possible. So far, Steinert has used the laser on four patients this year, including two this week.

Rejuvenating the eye Two weeks ago, Steinert and a Who’s Who of eye-tech entrepreneurs were at an annual meeting of cataract and refractive surgeons in San Francisco, where the buzzword was presbyopia.

Several companies are counting on aging baby boomers to want to stop the march of time in their eyes. Boomers may be a captive audience because they’ve been exposed to cosmetic procedures such as LASIK and Botox.

They’re living longer and some want to maintain an active lifestyle that does away with glasses and contact lenses. And they don’t want to struggle with high-tech devices such as a PDA, a handheld or dashboard GPS and the ever-shrinking mobile phone.

Here’s how some locally developed companies are attempting to boost vision, especially in people with presbyopia: Advanced Medical Optics in Santa Ana, makes artificial lenses (often known as intraocular lenses). Its ReZoom multifocal lens was approved in 2005 by the Food and Drug Administration (FDA) for treating cataracts. But eye surgeons can and have been using the lenses in patients who don’t have cataracts, said Ron Bach, vice president of worldwide marketing for AMO.

Surgeons use a tiny probe that vibrates to break up and liquefy the cataracts on the eye’s crystalline lens, then gently sucks out the debris.

Then, surgeons insert a foldable intraocular lens inside the eye to replace the crystalline lens. This artificial lens has five zones that enable many patients to see near, intermediate and far distances in a variety of light conditions.

ReVision Optics in Lake Forest makes a different kind of implantable lens, one that requires less invasive surgery, said Randy Alexander, president and CEO. Surgeons use either a femtosecond laser or a cutting instrument called a microkeratome to create a flap on the surface of the cornea. They fold back the flap and place the lens inside the eye where it changes the shape of the cornea. Unlike other implantable lenses, it does not replace the crystalline lens of the eye.

ReVision hopes to eventually tap into the LASIK market. About 5.19 million people have had LASIK from 1996 to 2005, according to VisionWatch, a study conducted by Jobson Publishing LLC and the Vision Council of America. Many are candidates for another surgery.

Presbyopic patients who have had LASIK have an advantage because they already have a flap on the surface of the cornea that can be folded back for implanting the ReVision lens. The lens is in clinical trials and could be available in the U.S. in two to three years.

Late last year, Aliso Viejo-based eyeonics inc. released an upgrade of its crystalens, called crystalens SE. The SE stands for “squared edge,” a design feature that blocks cells from growing and causing distortions in vision after the artificial lens is implanted, said Andy Corley, eyeonics’ chairman and CEO. Crystalens is an accommodating lens — it moves like the eye’s natural crystalline lens. The FDA approved it for treating cataracts and presbyopia in 2003.

Refractec Inc. in Irvine is conducting trials to get FDA approval for another application for NearVision CK (conductive keratoplasty).

CK, a procedure in which radio waves tighten the cornea, was approved for presbyopia two years ago. Surgeons have been using this procedure off-label in patients who have had LASIK. But Refractec wants FDA approval so the company can market the new application to people who have had LASIK, said CEO Mitch Campbell.

The procedure does not involve any cutting or suturing because the radiowaves are delivered through a probe thinner than a strand of human hair.

Finally, AMO is conducting studies on Presby CustomVue, which involves several technologies. Surgeons map the inner dimensions of the eye and use these measurements as a guide in reshaping the cornea with an excimer laser. Essentially, it’s custom LASIK for the presbyopic eye. AMO’s Bach estimated that it’s less than three years away from approval in the U.S.

As for the future, venture capitalist Link sees “Supereyes” on the horizon.

“It’s no longer just about restoring the vision that people once had,” Link said. “People will have the option for vision that’s better than what they were born with.”

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Copyright (c) 2006, The Orange County Register, Calif.

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