Private equity interest helps de-risk the future

Prominent N.E. practices plot a path for growth, with help.

By René Luthe, senior editor

Ophthalmic Consultants of Connecticut (OCC) and New Vision Cataract Center (NVCC) are poised for further growth in their markets, thanks to a new strategic relationship with Spectrum Vision Partners. OCC now has four locations in Connecticut, while ASC NVCC has two operating rooms in Norwalk, Conn.

Spectrum Vision Partners is a young entity itself, having been formed last October when Ophthalmic Consultants of Long Island (OCLI) joined forces with Blue Sea Capital LLC. Blue Sea signed a definitive agreement for an investment into Spectrum Vision, a management services organization formed to administratively support OCLI’s growth in its Long Island market, as well as future affiliations with eye-care practices in the tri-state region. At the time of the agreement, OCLI had 15 sites across New York’s Nassau and Suffolk counties and 400 employees. OCLI’s physician partners maintained their roles with the group and received “significant ownership” in Spectrum Vision Partners, according to a company press release.

The new strategic relationship with OCC and NVCC “marks Spectrum Vision Partners’ first affiliation within a month of our formation as part of our tri-state strategy,” notes Tom Burke, Spectrum’s CEO.

Eric Donnenfeld, MD, a partner at OCLI and now Spectrum, explains private equity partnerships this way: “Ophthalmic Consultants of Long Island and Connecticut were two separate practices that have both had a clear vision and mission, and that was to simply provide the best-in-class ophthalmic care to our patients. After an exhaustive search and interviewing dozens of private equity companies, it became clear that Blue Sea Capital had the same vision and would partner with OCLI and OCC in every sense of the word to expand and improve on our model of patient care.”

More announcements, he added, could be expected over the coming months. OM

Canadian meeting weighs glaucoma progression, more

Glaucoma pearls from the Great White North.

By Louise Gagnon, contributing editor

Leading Canadian ophthalmologists at the Walter Wright symposium in December discussed various clinical pearls for community clinicians to keep in mind when they see their patients with glaucoma.

• Speed matters. Whatever the metric used, ophthalmologists should be measuring the rate of change in their glaucoma patients. In a panel discussion about measuring visual fields to detect progression of disease, clinicians agreed that the rate of change is the key measure to obtain from patients with glaucoma.

“The importance of measuring visual field progression with time-trend analysis is that it assesses the rate of change, which is what we should be looking at,” said Marcelo Nicolela, MD, professor and head, department of Ophthalmology and Visual Sciences at Dalhousie University in Halifax, Nova Scotia.

“The important question isn’t if patients are progressing, but rather how fast they are [progressing],” Dr. Nicolela says. Measuring patients’ status over a sufficient period of time confirms that most patients’ glaucoma progresses.

• Tonometer tips. Monitoring IOP in glaucoma patients is a significant calculation, and a one-size-fits-all approach in obtaining that measurement with the Goldmann applanation tonometer is not generally prudent, according to Yvonne Buys, MD, FRCPC, a professor in the department of Ophthalmology and Vision Sciences, University of Toronto, and incoming president of the Canadian Ophthalmological Society.

In a patient whose corneas are thick and more rigid than normal, for example, Dr. Buys said that the Goldmann may not be the ideal technology to use. Instead, ophthalmologists should opt for the PASCAL Dynamic Contour tonometer because it is mounted on a slit lamp and can measure IOP regardless of corneal biomechanical factors.

• Drug interactions. The complicated web of drug interactions: Drugs that are prescribed for glaucoma, such as alpha agonists, should not be prescribed for patients who take tricyclic antidepressants and monoamine oxidase inhibitors, according to Jeff Martow, MDCM, an ophthalmologist and division head at the Markham Stouffville Hospital in Markham, Ontario.

Overall, said Dr. Martow, ophthalmologists should have at the top of mind possible toxicities linked to commonly used glaucoma medications, a further reason for ophthalmologists to take a detailed patient history.

Dr. Martow also dispelled myths about avoiding prescribing other glaucoma medications in certain populations. Ophthalmologists do not need to avoid prescribing carbonic anhydrase inhibitors (CAIs) in patients with sulfa allergy for fears of allergic reactions, he said.

“There is an absence of cross-reactivity with sulfonamide-based drugs,” explained Dr. Martow, but added that CAIs are better tolerated when administered topically rather than orally.

• Weighing MIGS. Minimally invasive glaucoma surgery (MIGS) has been studied in numerous clinical trials and has been shown to produce a significant reduction in IOP in the longer term, specifically up to 24 months, according to Malik Y. Kahook, MD, chief of Glaucoma Service, University of Colorado School of Medicine, arguing that MIGS is evidence-based medicine. Dr. Kahook also is the endowed chair in Ophthalmology.

But Pradeep Ramulu, MD, MHS, PhD, director, Glaucoma Center of Excellence at Wilmer Eye Institute, said MIGS has not been properly compared to laser trabeculoplasty or trabeculectomy in clinical trials, suggesting its incorporation into evidence-based medicine in ophthalmology is premature. Dr. Ramulu is also an associate professor of Ophthalmology, Johns Hopkins University, Baltimore, Md. OM

Disclosures: Dr. Kahook is a consultant for New World Medical, Alcon and Allergan. He received patent royalties from New World Medical and Alcon.

Dr. Ramulu is a consultant to W. L. Gore & Associates Inc.

Dr. Nicolela, Dr. Buys and Dr. Martow reported no relevant disclosures.