Five Goals to Help Grow Pre-surgical Use of Avenova by Promoting Lid Hygiene
Physicians who use the product want to get it into more surgeons’ hands
JOHN SHEPPARD, MD, MMSc
What would it take for surgeons to acknowledge Avenova as “best in class?” Certainly, clinical science goes a long way, and further studies will help us make our point.
As I sat down with our esteemed group of physicians to discuss this subject, we came up with six additional goals:
1. Solve the Problem
As surgeons, our product is patient satisfaction. We all want a pre-surgical regimen that reduces inflammation, infection, or both before surgery and prevents complications after surgery. A lid hygiene regimen including Avenova can be part of a package solution.
2. Use Expert Guidelines
How do we use Avenova? A week before surgery? Once a day or twice a day? What’s the consensus? Surgeons don’t want to figure out how to use Avenova for their patients; they want a recommendation — a cookbook.
Fortunately, NovaBay frequently brings together key opinion leaders to discuss Avenova, and those leaders can provide that recommended regimen for new users to follow. That might include a different regimen for patients with neurotrophic disease, chronic ulcerative blepharitis, and other conditions we know to predispose patients to surgical morbidity.
3. Think Packages and Partners
Avenova has a place in “package deals” (combinations of things that we’re already doing). Many physicians already place Avenova in a blepharitis package or kit along with LipiFlow (TearScience) and other treatments.
For surgeons, that same package might be the pre-surgical regimen for routine cataract surgery or a “premium package” for premium lenses. There are many new treatments for blepharitis, including LipiFlow, MiBoFlo (MIBO Medical Group), BlephEx (Rysurg), and Maskin probe (Rhein Medical). All can benefit from peri-operative ocular surface maintenance.
Spelling Out Avenova’s Benefits
Currently, we do not have hard scientific numbers that demonstrate how Avenova reduces the risk for surgical infection. However, we do know that Avenova reduces the bacterial load without the attendant risk of bacterial resistance when using antibiotics. In other words, Avenova has great potential to reduce the risk of infection.
There are many types of ocular surgery, and all of them might benefit from reducing topical bacterial colonization preoperatively. For example, surgeons who perform plastic surgery emphasize the importance of reducing lid colonization at the margin, skin, and cul-de-sac.
The most common ocular procedure now is intravitreal injection. The current thinking is that topical antibiotics before intravitreal injection make no sense at all due to induced microbial resistance, but there are some better ideas floating around about how to reduce the risk of endophthalmitis. Avenova has the potential to be part of that plan.
Finally, Avenova would be a wonderful option for patients whom we reluctantly give chronic topical, antimicrobial therapy: bandage contact lenses, persistent epithelial healing defects, and the Boston Keratoprosthesis come to mind. These patients are more severely afflicted with chronic infection, so we break the rules and prescribe the weakest antibiotic possible. Avenova makes much more sense for this subset.
I know these packaged kits contain a convenient set of recommendations that saves us chair time as well as staff confusion. When we look at the treatments we’re packaging together, it’s easy to find manufacturers with whom we can collaborate for research and product marketing.
4. Develop New Delivery Systems
As my colleagues and I discussed the importance of having delivery system options, the most popular idea was an ocular surface mist spray. There are currently two technologies available for this delivery route, but we don’t know if either one is the optimal way to deliver Avenova. It would also require extensive research into concentrations and toxicities to offer Avenova as a mist.
Different vehicles are possible as well. For example, if we want Avenova to stay on the lids, a gel form may be best, while adhesion to the ocular surface might best be facilitated by an emulsion. And patients may even benefit from a combination with a nonprescription product, such as a hyaluronic acid or an antioxidant.
5. Embrace New Products
My colleagues and I could brainstorm new product ideas forever. Avenova may have value beyond lid and lash hygiene. In fact, Avenova should exert its effect upon any cutaneous surface on the body.
To avoid confusion, future products could be named according to their intended use, the same way manufacturers name skin care products. With products called Avenova Lid & Lash Hygiene, Avenova Scalp Hygiene, or Avenova Skin Hygiene, physicians would easily distinguish one product from another.
New products also could touch on unmet needs in other specialties where inflamed mucous membranes are an issue. NovaBay could package other products with Avenova as well, just as they already do with nutraceuticals. Because NovaBay has a much-needed product in Avenova, new approaches that clearly say, “Here is the answer to your problem” have a good chance to connect more physicians with the product.
John Sheppard, MD, MMSc, is the president of Virginia Eye Consultants, COO of EyeRx Research, Inc., and founder of ProVision-Network.com. Dr. Sheppard is also a professor at Eastern Virginia Medical School in Norfolk. |
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