Dr. Mali's top 5 predictions in ophthalmology for 2017

The great thing about making predictions is that it is basically a win-win proposition: if you are correct in your predictions, you are celebrated for being a sage. If you are incorrect, you have the opportunity to learn from them and make better predictions for the next year. Wishing everyone a Happy New Year and a successful 2017!

Editor’s Note: Welcome to “Eye Catching: Let's Chat,” a blog series featuring contributions from members of the ophthalmic community. These blogs are an opportunity for ophthalmic bloggers to engage with readers with about a topic that is top of mind, whether it is practice management, experiences with patients, the industry, medicine in general, or healthcare reform. The series continues with this blog by Joshua Mali, MD, a vitreoretinal surgeon at The Eye Associates, a private multispecialty ophthalmology practice in Sarasota, FL. The views expressed in these blogs are those of their respective contributors and do not represent the views of Ophthalmology Times or UBM Medica.

1) The number of cataract surgeries in the United States will continue to rise

I thought I would start out with an obvious prediction but nonetheless a very significant one. Reflecting on the history of cataract surgery and where we are today, this is an amazing milestone and should be applauded. In 2015, there were approximately 3.6 million cataract surgeries performed in the United States¹ and I expect a much higher number in 2017. The fact that we continue to see increases in the number of cataract surgeries not only represents more baby boomers requiring surgery (thus addressing a critical need in our community), but also the fact that we are able to perform the massive volume of surgeries more efficiently, safely, and with the most advanced surgical techniques and technology.

2) The healthcare law will change in a significant way

Whether it is complete repeal of the Affordable Care Act (ACA) or adjustment to existing healthcare law, the majority of Americans can agree that there will be a significant change in healthcare in 2017 which could reshape the way we practice medicine for years to come.

3) The fluocinolone acetonide intravitreal implant will have a breakout year

The fluocinolone acetonide intravitreal implant (Iluvien, Alimera Sciences) represents an exciting new class of treatments that I designate as the long-term implant therapy model and appears ready to take off in ophthalmology as a promising treatment modality. As I have described in previous articles, the implant is a nonbiodegradable implant designed to deliver a continuous microdose of fluocinolone acetonide (FAc) to treat diabetic macular edema (DME). This idea of continuous treatment for DME is appealing given the chronic nature of diabetes and the need for sustainability of sufficient levels of medication intraocularly over a prolonged period of time.

4) Aflibercept utilization will be at the highest levels

Aflibercept (Eylea, Regneron) has consistently demonstrated excellent efficacy in age-related macular degeneration (AMD), DME, and retinal vein occlusion (RVO) and I expect even more utilization across the board among retinal specialists. For example, based on the 2016 ASRS PAT survey, retinal specialists in the United States would use aflibercept 79.5% of the time in new-onset exudative AMD patients if the cost were the same among all medications.²

5) There will be more mergers/acquisitions in the ophthalmology industry

Johnson & Johnson's acquisition of Abbott Medical Optics (AMO) was an impressive and bold corporate maneuver to gain additional exposure in the rapidly growing and dynamic ophthalmic industry. In my opinion, this seems like the beginning of additional pharmaceutical giants acquiring key players in the ophthalmic industry to gain market share in our innovative sector. I would not be surprised to see another big merger like this in 2017.

References

1) https://www.reviewofophthalmology.com/article/thoughts-on--cataract-surgery-2015

2) 2016 ASRS Preferences and Trends Survey

Joshua Mali, MD, is a board certified vitreoretinal surgeon at The Eye Associates, a private multispecialty ophthalmology practice in Sarasota, Florida. He can be reached at 941-923-2020. He is currently a consultant and shareholder at Alimera Sciences.