Instrumentation evolves amid changing market

Ophthalmic surgical instrument manufacturers and distributors work in a constantly evolving and increasingly global marketplace and, in late 2009, are meeting challenges posed by new procedures and changing government regulations. Rhein Medical's intraductal meibomian gland probe.

"We are constantly challenged by the phaco companies when they come out with their new systems to design instrumentation around them, such as downsized surgical blades, capsulorhexis forceps, or any other kind of product that will [meet] a specific incision requirement," said John Bee, president and chief executive officer of Rhein Medical. "That's generally the challenge that we have from month to month, to try to keep up with the technology for lenses, phaco tips, and procedures."

While keeping up with these demands, Rhein has launched a surgical product to address another aspect of eye disease: dry eye and meibomian gland disease. The company recently introduced an intraductal meibomian gland probing system developed in collaboration with Steven L. Maskin, MD, of Tampa, FL.

"This is a brand new technique that attacks meibomian gland dysfunction right at the source," Bee said. "It's something that we're really excited about, and the patients are benefitting quite a bit."

For single use

Instrument makers also are responding to higher demand for single-use instruments while not abandoning their reusable instrument lines and keeping an eye on regulatory changes that could affect instrument use.

BD Medical–Ophthalmic Systems has been marketing single-use instruments for decades, but the company began observing an upsurge in this sector a few years ago, starting in Western Europe. Instruments that traditionally had been reused, such as forceps, needle holders, manipulators, and specula, were becoming single-use.

BD has two lines of single-use instruments; one is made entirely of stainless steel of a quality similar to the reusable instruments but at a much lower price, while the other consists of tools with steel tips and plastic handles. The stainless steel line, which includes about 30 instruments, had a major launch this fall. The selection is more limited in the plastic and steel instrument line.

BD has also introduced a tray with multiple slots that can be customized to hold up to a dozen of the tools a particular surgeon most frequently uses for a procedure. This product is more efficient, since all of the tools are in one place, and cost-effective, because there is no need to open multiple packs of single-use instruments.