EyeWorld Asia-Pacific December 2012 Issue

9 December 2012 EWAP FEATURE A bullish outlook for lasers by Michelle Dalton EyeWorld Contributing Writer Laser growth is being driven by the femtosec- ond for refractive cataract surgery and a burgeoning replacement market “ S urvival of the fittest” aptly applies to businesses in a global downturn like the one that’s currently ongoing, but several laser manufacturers and analysts believe the excimer and femtosecond markets are in the midst of a true turnaround. Frank Ziemer, president and chief executive officer, Ziemer Ophthalmic Systems, Port, Switzerland, said with countries like Spain and Greece possibly being forced out of the euro, it’s “next to impossible” to predict the European economic picture even 6 months from now. “We believe that companies have to offer better laser technology,” he said, adding in Europe it may take 4-6 months to identify potential clinic customers. At Bausch + Lomb (Rochester, NY, USA), Calvin W. Roberts, MD , executive vice president and chief medical officer, said he’s “very bullish” on the laser market— especially in the replacement laser market. Bausch + Lomb and Technolas Perfect Vision (TPV, Munich, Germany) are currently co-promoting the Victus Femtosecond Laser Platform. “The sweet spot for us is presbyopia,” he said. “Our excimer business in Europe is very good. SUPRACOR from TPV is not approved in the U.S., we expect substantial growth once it is approved.” Over the next 10 years, there will be a resurgence in consumer demand for LASIK, said Shareef Mahdavi , president, SM2 Strategic, Pleasanton, Calif., USA. “We’re seeing innovations on top of incremental improvements and a much better acceptance on the consumer level,” he said. The recent global recession has created a large pent-up demand for refractive surgery, said Paul M. Stubenbordt , founder, Stubenbordt Consulting, Roanoke, Texas, USA, but he’s still a bit on the bearish side. “Right now, it’s an anomaly with how well the U.S. laser market is doing,” he said, with no single geographic region in the U.S. faring better than any other, although the Northeast seems to have recovered more quickly than other areas. The femtosecond market, on the other hand, is all about product innovation and is where the excimer market was about 15 years ago, Mr. Mahdavi said. “Excimer was about corneal reshaping, but we’ve got a much more versatile tool in femtosecond technology. It’s driving a replacement market with excimer lasers,” he said. Dr. Roberts said between the “great new technology that’s coming out” and consumer desires to have a laser-based presbyopia treatment, numerous markets are showing great potential. Bausch + Lomb is “very big” in Southeast Asia, with Singapore a main area for refractive surgery growth, Dr. Roberts said. Australia and China are growth areas as well, as the Chinese “have not really embraced refractive surgery, but it’s a huge contact lens market for us.” Excimer markets Consumer demand will drive the excimer market, as the devices are less expensive and more efficient, Mr. Mahdavi said. He predicts a large growth market in India and China, with the U.S. a predominant replacement market. “Consumer demand isn’t what is was in 2007, so physicians have been holding back on purchasing decisions,” he said. “So now the question is whether they outright replace older units or upgrade what they currently have?” He cites both the Allegretto (Alcon, Fort Worth, Texas, USA/Hünenberg, Switzerland) and the VISX custom treatment (Abbott Medical Optics, Santa Ana, Calif., USA) as a cause for the growth. “Right now, VISX has a majority of units placed—about 62%—but only 51% of the overall procedures performed,” he said, adding Market Scope (St. Louis) data suggests 80% of new laser sales are Allegretto lasers. After the introduction of the Allegretto, “patients did start having even better outcomes, and since then, no major technological advancement has occurred,” Mr. Stubenbordt said. Mr. Ziemer said Korea, Taiwan, Japan, and China are driving the Asia-Pacific replacement market. In Spain, however, where overall unemployment hovers around 25% and for younger people unemployment is closer to 40%, “there is almost no business in the private refractive market,” Mr. Ziemer said. Larger laser chains “always look to improve their technology,” which presents potential growth areas as well, he said. Mr. Mahdavi said the rise of the middle class in less developed nations (India, China) will also help spur the refractive industry, but warned a lower cost entrant may be welcomed in some Asian countries (notably, China). continued on page 13