IN SO MANY WORDS

Lumenis’ Itay Mayer

In So Many Words is a timely chat with an ophthalmic industry thought leader.

Itay Mayer

Itay Mayer, global marketing director for Lumenis Vision, is a modest man. Asked to give his background for this interview, he discussed his work with an agro-tech company in the United States and his three years as a management consultant at McKinsey & Company, including one South African project for a $45 billion consumer packaged-goods conglomerate.

But he left out the good stuff, like his seven years (and one month) with the Israeli Air Force, leaving with the rank of captain, and, in 2004, the award for Chief of Staff Distinguished Officer. As head of the air force’s revenues section, he managed large acquisition and infrastructure projects, many involving other countries. But ask him about the salient facts. “I’m okay with [you] mentioning my background with the Israeli Air Force, but with not too many details.”

Ophthalmology Management: How did you arrive at Lumenis?

Itay Mayer: I got a call from [someone I] knew at Lumenis, who was a good friend from the McKinsey days. I was highly impressed with the history of Lumenis in ophthalmology, the portfolio, the great people I met and the company’s promising future. It didn’t take me too long to jump into the water.

OM: How does IPL work?

IM: In skin diseases such as rosacea, abnormal blood vessels form under the surface of the skin. These abnormal blood vessels release pro-inflammatory mediators, which can easily propagate to the eyelids. When this happens, inflammation of the eyelids and the meibomian glands often follows.

IPL, which was invented by Lumenis, is a brief pulse of intense light that destroys abnormal blood vessels and removes a major source of inflammation to the eyelid. IPL is also effective in exterminating Demodex, a skin parasite that is abundant in rosacea. This parasite is infested with bacteria.

Killing Demodex would reduce the bacterial load on the eyelid, and therefore decrease inflammation.

OM: Tell us about the company’s history.

IM: Lumenis is a result of a merger between a number of leaders in the medical laser industry, including Coherent Medical and ESC. The IPL technology was invented by ESC years ago, in the mid 1990s.¹ IPL was used then to treat skin for hair removal and skin problems, like rosacea and port wine stains. Potential application for meibomian gland dysfunction became apparent in 2002.

An ophthalmologist in Tennessee named Rolando Toyos, MD, wanted to open an aesthetic clinic, so he bought IPL. Because he was an ophthalmologist, he noticed a difference in patients who had dry eye symptoms.

OM: Then what happened?

IM: Perceptions changed. In 2002, dry eye was considered a syndrome, not a disease. Since then, the perception of the market has changed, and perception of IPL has changed. Dry eye is a disease, and the percentage of the dry eye population that is suffering is huge, especially those with MGD. If they don’t get treatment as soon as possible, the symptoms get worse.

Also, what has changed is the understanding that the root cause of MGD is inflammation. But our product is not yet FDA-approved for MGD.

OM: But surely you are working toward approval?

IM: Right now, we are offering a solution for skin inflammation, such as rosacea. Yes, there is a high correlation between rosacea and MGD; most rosacea patients have MGD.²

If you think about it, the eyelid is part of the face skin. If you have skin inflammation on the cheek, the inflammation will go up to the eyelids. There are already a few studies by Duke, Mayo Clinic and others regarding the efficacy of IPL treatment for MGD.

A retrospective study in Cornea shows 81 patients with dry eye symptoms who were treated with IPL and meibomian gland expression. It finds that a combination of both treatments significantly improved symptoms, in 89% of patients, and meibomian gland function in 77% of patients in at least one eye.³

OM: Where does IPL stand in other countries?

IM: It is registered internationally in many other countries. In different countries, registration is a big difference. It could be registered as a technology and not an indication. We are promoting the correlation between rosacea and MGD, and what IPL is good for.

OM: As an international company, what is it like working with the rest of the world?

IM: I’ve always enjoyed working with people from all over the world. The key success factor, in my opinion, is to adjust everything you do to the market you’re facing. The different markets are very different culturally and business wise.

OM: Back to IPL. What makes it different from other dry eye treatments?

IM: First, let me say that doctors need more tools to treat dry eye; therefore more research needs to be done. IPL is interesting because it is targeting the root cause of the problem, which is often skin inflammation or rosacea. It’s a cash-based treatment — it is cleared for around 30 different skin indications — so it’s a great way for a practice to expand into aesthetic services. More doctors are looking to add cash-based products.

OM: You think there is room for more dry eye products?

IM: In order to treat dry eye effectively, doctors will need to have many tools in their toolbox. We think IPL will evolve to become a significant tool in the dry eye toolbox. OM

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