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`UCHealth Eye Center lands global innovation
`award s
`For the world's most innovative eye center, look no further than the University of Colorado
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`By: Todd Neff, for UCHealth � January 6th, 2016
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`Share
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`wThe Ophthalmologist Magazine's 2015 Innovation Awards were a
`global affair. The year's top 10 technologies included one each from Switzerland, Japan and South
`Africa; three from Germany; and four from the United States, including devices developed in
`Middleton, Wisc., and Orlando, Fla. The other two American inventions —including the innovation that
`took the top spot in the rankings —emerged from the same building on the Anschutz Medical
`Campus.
`
`That building is the UCHealth Eye Center. The
`technologies cited included the top-ranked Harmoni
`Modular IOL, an intraocular lens to treat cataracts; and
`the Kahook Dual Blade, whose fine-tuned slicing relieves
`pressure in the eyes caused by glaucoma.
`
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`The Harmoni Modular IOL (intraocular lens), in clinical
`trials outside of the United States, shows great
`promise for patients with cataracts. It consists of a
`base platform and a separate replaceable optic. Both
`pieces are inserted through a 2.2 millimeter incision.
`Courtesy ClarVista Medical, Inc.
`
`The Kahook Dual Blade, which came in at number 7 in
`The Ophthalmologist's rankings, borrows its name from
`its inventor, Malik Y. Kahook, MD, professor of
`Ophthalmology and vice chair of clinical and translational
`research at the University of Colorado School of
`Medicine. The Dual Blade provides a straightforwar d
`inexpensive way to treat a disease that afflicts an
`estimated 3 million people in the United States and 60
`million people worldwide, according to the Glaucoma Research Foundation .The World Health
`Organization has pegged glaucoma as the second-leading cause of blindness.
`
`There are two main ways to treat the high intraocular fluid pressure that is glaucoma s hallmark.
`is to shut off the faucet; the other is to open up the drain. The dual blade targets the drain —
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`specifically, something called the trabecular meshwork. Through a corneal incision of just 1.2
`millimeters, the stainless-steel blade can neatly excise strips of the mesh to let the fluid flow again
`(this animation shows the Dual Blade in action).
`
`"There's no need for electricity and no moving parts," Kahook said. "That makes it cost-effective in a
`way that gives it global reach. Most countries in the world can't afford the expensive devices we have
`here."
`
`Kahook says he started working on the blade three-and-a-half years ago; New Word Medical, Inc.,
`which specializes in glaucoma drainage technologies, licensed the Dual Blade and has led it to
`market. In addition to being available in the United States, the device is approved in several
`countries, Kahook says, including Canada, which approved it on Dec. 22. Kahook expects the Dual
`Blade to be approved in Europe in early 2016.
`
`CU Ophthalmologist Leonard Seibold, MD, an Eye
`Center glaucoma specialist, says he has used the
`Kahook Dual Blade on mild, moderate and severe cases,
`and has paired it with cataract surgery with success. The
`device "carries more risk than our in-office laser
`treatments that are non-incisional," he said, but "has
`allowed for faster recovery and less risk of vision-
`threatening complications" than traditional glaucoma
`surgeries.
`
`"I really like the simple, yet elegant design of the device,"
`Seibold said. "Many devices have been used to
`accomplish this over the years, but none have achieved
`it in a manner so simple yet so complete."
`
`The Kahook Dual Blade, whose micro-machined blade
`can precisely remove trabecular meshwork in the eye,
`allowing fluid to escape the eye of a glaucoma patient.
`Courtesy New World Medical, Inc.
`
`The Ophthalmologist's judges agreed, saying the device will enhance patient safety, lower costs, and
`enable procedures in underserved areas.
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`Harmoni tops list
`
`Kahook was also co-inventor of the Harmoni Modular
`IOL, which he developed with colleague Naresh
`Mandava, MD, chairman of the CU School of Medicine's
`Department of Ophthalmology. The target here is
`cataracts, a clouding of the eye's lens. According to the
`National Eye Institute, cataracts are among the leading
`causes of vision loss and blindness, afflicting an
`estimated 25 million people in the United States and
`more than 150 million people worldwide. By age 80, half
`of Americans either have a cataract or have had cataract
`surgery, the institute says.
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`Malik Kahook, MD.
`
`Cataract surgery involves replacing the clouded lens with
`an artificial one that's anchored in something called the
`intraocular capsular bag. With traditional intraocular lens replacement, once the new lens is in, it's
`usually in for good, Kahook says.
`
`
`
`"Removing a traditional lens is a problem because it can tear the capsular bag and can cause great
`harm to vision," he said.
`
`Yet often, patients would benefit from a replacement lens. Cataract surgery is happening earlier and
`earlier, and replacement lenses could help the eyes adjust to changes that occur over time. In
`pediatric cases, the ability to exchange lenses would change the game, Kahook says. Also, new
`lenses could help patients cope with the progression of eye disease, such as glaucoma and macular
`degeneration, that emerge after cataract surgery, Kahook says. And then there's the march of
`progress.
`
`"Technology changes," says Kahook, "So there may be a new lens technology that comes along in 10
`years, and if you already have a lens, you're out of luck."
`
`With Harmoni the base platform is anchored in the capsular bag like a traditional lens. But the optic
`portion, which focuses light to produce crisp vision, can be replaced as a patient's needs — or the
`technological state-of-the-art —changes. The decoupling also lets ophthalmologists rotate the lens as
`needed, which could enable corrections for problems like astigmatism. (Check out this animation of
`the frame and lens being inserted through a 2.2-millimeter incision and unfurling like butterflies from
`their cocoons).
`
`Game changer
`
`The Harmoni lens, licensed to ClarVista Medical, Inc., remains
`experimental in the United States, but since late 2013 it has
`shown excellent results in overseas trials, Kahook says. It
`received its CE mark in Europe in September; the company is
`hoping to hit the U.S. market in 2019, he says.
`
`The judges considered Harmoni to be revolutionary; Richard
`Davidson, MD, a CU Ophthalmology professor and specialist in
`cataract, cornea, and refractive surgery, agreed. He says he's
`looking forward to the device being approved.
`
`"I think it's really going to change how we look at cataract
`surgery," he said.
`
`He added that innovations of the sort happening at the UCHealth
`Eye Center have a wider impact on the institution.
`
`Naresh Mandava, MD.
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`"The fact that we're in this environment and have built this culture where translational research really
`works adds to the collegiality and camaraderie of what we do here," Davidson said.
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`Kahook says the lens could help with more than cataracts.
`
`"Once you've uncoupled the optic from the base platform, you've opened the intraocular lens to a
`whole new world of innovation," he said.
`
`Kahook intends to help open up that world and others. He says he, Mandava, and their colleagues
`are always coming up with ideas —though 99 percent of the time, someone's already working on it.
`
`"But every now and then, we think of something and we look at each other and ask, `Why didn't
`anybody think of this before?"'
`
`At that point, inspiration cedes to perspiration and the experience necessary to make viable products
`happen, he says. They quickly kill flawed ideas; they partner on campus and off to move promising
`ones out of the lab quickly.
`
`"We do a really good job of figuring out what's going to work or not," Kahook said.
`
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`About the author
`
`Todd Neff. for UCHealth
`
`email the author
`
`Since 2008, Todd Neff has written hundreds of stories for University of Colorado Hospital and UCHealth.
`He covered science and the environment for the Daily Camera in Boulder, Colorado, and has taught
`narrative nonfiction at the University of Colorado. He was a 2007-2008 Ted Scripps Fellowship recipient
`in Environmental Journalism at CU.
`
`His latest book, "The Laser That's Changing the World," tells the story of the inventors and innovators
`who saw, and ultimately realized, the potential of lidar to help solve problems ranging from smokestack-
`pollution detection, ice-sheet mapping, disaster recovery, and, ultimately, autonomous-vehicle guidance,
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