Friday, April 05, 2013

A Personal Journey: How I Went From Being A Bench Chemist to An Expert Resource in Ophthalmology and Medical Lasers

A short while ago, I was asked by Maureen Duffy, editor of VisionAware, the blog of the American Foundation for the Blind, how I became so knowledgeable about ophthalmology and why I started my blog. I prepared some background information for Maureen and she published it as a guest blog on her site, but because of space limitations, she was only able to use an abridged version. Since I don’t have the same space limitations, I decided to publish the “unabridged” version here.

So, here is my story:

The Beginning of My Career in Chemistry

I graduated from the Univ. of Massachusetts in Amherst, MA in 1957 with a B.S. degree in organic chemistry. After three jobs in industry (The Refinery Technology Laboratory of Gulf Oil in Philadelphia – analyzing oils and gas products from the refinery; the Container & Sealant Lab at the Dewey & Almy Div. of WRGrace in Cambridge, MA – working on cap and can sealants for baby food and peanut butter jars and aerosol can valves; and The Exploratory Development Lab at United-Carr Inc. in Watertown, MA – working on adhesives to replace fasteners for automotive applications), I joined the staff of the Product Technology Section of Arthur D. Little (ADL) of Cambridge, MA, the international consulting firm, in March 1969, as a laboratory bench chemist.

Over my twenty-five years at ADL, I worked on hundreds of projects. Among the more memorial assignments were being part of the team that developed the “all plastic pencil” for the Empire Pencil Company (part of Hasbro Toy); working on the development of an erasable pen ink compound for Bic Pen; trying to produce a protective plastic liner for glass Thermos bottles (to protect the food contents of the bottles when school children hit their neighbors on the head with their lunch boxes – which proved a technical success – water, soup and coffee stayed hot overnight, but failed miserably, as the plastic liner took the flavor out of the coffee making it taste terrible!); developing a spin-cast epoxy eyeglass frame compound and manufacturing process for Universal Optical; developing an improved firefighter’s glove for NIOSH and NASA; the development of a unique, disposable, no moving-parts mixer for use in dispensing two-part epoxy and urethane adhesives for the MPB Corporation (now commonly used in all dentist’s offices for dispensing casting compounds and sold in hardware stores for delivering reactive adhesives and sealants); and of course being a part of the team that built and flew a lead balloon to prove that lead balloons really could fly! (In fact I tried to launch the silk purse made from sow’s ears in a basket beneath our lead balloon!)

I have written the stories behind many of the above inventions and products in my “other” blog, ADL Chronicles.

An Introduction to Soft Contact Lenses

One of my first assignments at ADL (along with working on chemically stabilizing soils for soft ground tunneling) was to see if there were other uses for hydroxy ethyl methacralate (HEMA), the material that soft contact lenses were composed of. National Patent Development Corp. (NPDC), which had acquired the Czech technology and licensed it to Baush & Lomb, wanted to know if this product could be used for other applications. We thought of applying it to the hull of boats to make them more slippery (and go faster in water and reduce adhesion of barnicles), but the best I could come up with was its use as a slow release reservoir for insecticides to kill mosquito larvae in swampy areas.

A few years later, in June 1972, and because of my knowledge of the properties of HEMA, NPDC asked me to lead a study on the “safety and efficacy” of the B&L Soflens, which had just been approved for marketing (March 1972). (NPDC was going to issue some stock to the public and the underwriters needed this due diligence report for the offering.) The study involved interviewing all of the original FDA clinical investigators for the Soflens. The knowledge about soft lenses I gained led to several papers about the “Outlook for Soft Lenses” that were published by ADL’s Decision Resource Division. Those publications led, over the next fifteen years, to over 150 assignments in the soft lens industry, including about 50 briefings to companies interested in both the technology and financial aspects of soft contact lenses. (How was B&L making so much money with their Soflens business?) It also led to my assisting Johnson&Johnson (Vistakon), Ciba Geigy (CibaVision), and Schering Plough (Wesley-Jessen) in their acquisitions of technology or small companies, to enter the soft lens industry. (In essence, I became the “guru” of the soft contact lens industry!)

Ophthalmology, Lasers and Writing

The soft lens assignments led to assessments of intraocular lenses (IOLs), plastic eyeglass lenses and eventually, in 1983, the just FDA-approved YAG ophthalmic lasers for correcting capsule opacities following cataract procedures. In 1985, I became involved with surgical lasers and in 1986 wrote the first comprehensive research and market report on medical lasers, “Medical Laser Systems: The Surgical Revolution”, that was published by Arthur D. Little’s Decision Resources Division. This was followed by a second comprehensive report on medical lasers, “The Outlook for Medical Lasers: The New Technologies”, published in 1988, also by Decision Resources. That led to my second career at ADL,  involving ophthalmic and medical laser consulting.

In the summer of 1985 I attended a Gordon Research Conference on lasers used with biological materials, where I met many of the leading researchers and surgeons involved in ophthalmic and medical laser technology. In December 1985, I was asked to prepare a market report about the potential for the excimer laser to correct vision. That report, about what I called LRK (Laser Photorefractive Keratectomy), became PRK, or ablation of the surface of the cornea to correct vision. My report was used to raise funds to begin one of the first excimer laser companies, Tauton Technologies (which later acquired VISX and assumed the VISX name).

That led to my entry into consulting in refractive lasers and writing the first market reports about refractive surgery in the mid-1980s and early 1990s. (I later wrote the seminal report on the future of laser refractive surgery for Summit Technoloy in 1992, wherein I predicted that the excimer laser would gain FDA marketing approval would occur by mid-1995. As I recall, I believe I was off by about 4 months.)

As I had begun attending ophthalmic and medical laser industry meetings (AAO, ASCRS, ARVO, ASLMS), I started writing about what I learned at those meetings. I first began writing columns for Vision Monday in 1988, mostly about my contact lens-related work. In 1989, I was asked to write a monthly column for Ophthalmology Management which became my Technology Update column. (Ophthalmology Management stopped publishing in the spring of 1991.) In the fall of 1991, Ocular Surgery News asked me to continue my Technology Update columns for them. This monthly feature, mostly covering new technologies that I discovered at the ophthalmic meetings, ran for over eleven year in OSN.

I was among the first to write about “custom ablation” and LASIK. One of my favorite titles from those times was, “Inlays, Onlays, Rings & Things” which described alternatives to laser refractive surgery.

Retirement and Spectrum Consulting

Finally, in March of 1994, on the anniversary of my 25th year with ADL, I retired from ADL and started my own consulting firm, Spectrum Consulting, continuing my consulting work in ophthalmics and medical lasers. In the fall of that year I started publishing Executive Laser Briefing, a monthly newsletter about current developments in the ophthalmic and medical laser industries. It was begun as an added service for my consulting clients, but I soon realized that others were interested in the publication. I began marketing the newsletter, which grew to a 40-60 page monthly publication, sent out to clients around the world, and it became a major part of my consulting business.

In December 2005, after eleven years, I  sold the newsletter and its client list to the publishers of Trends-In-Medicine, who continue to publish the newsletter today, renamed Executive Laser Report, and retired from active consulting.

A New Blogging Career Begins: Irv Arons’ Journal

That’s when I decided to begin writing my blog, Irv Arons’ Journal. It was originally started as a vehicle to place the more than 150 previously published articles online and accessible for historians and researchers, as I was involved in the beginning of several ophthalmic firsts – among them the birth of soft lenses, IOLs, ophthalmic lasers, refractive lasers, etc. Most of the articles were not available online because they were written prior to the explosion and availability of the web.

However, I quickly became diverted because I realized that I had insight into several new technologies that were entering ophthalmic use and I had access to those in the know who could provide me with the insight to write about these developments.

It all began because of some colleagues writing about what had happened the previous summer at the Retina 2005 Meeting in Montreal. Dr. Phil Rosenfeld presented information about his use of Avastin to stop the wet form of age-related macular degeneration (AMD) cold in its tracks and to provide improved vision to some patients. His presentation wowed the audience, but other than the retinal surgeons present at the meeting, no one else in the ophthalmic world was aware of the significance. I decided I needed to tell this story – Avastin: A New Hope for Treating AMD -- and so began my blogging career with an emphasis on new technologies for treating retinal diseases.

Since that start in December 2005, I now have over 270 articles posted online, mostly about new treatments for both dry and wet AMD, but also including writeups about new devices used to both treat and detect AMD.

Along the way, I have also written about the use of lasers to treat eye floaters, about the history and use of femtosecond lasers, including their use in treating cataracts, an overview of treatments for glaucoma, including the use of the then new SLT laser.

A Developing Interest in Stem Cells and Gene Therapy

Over the past several years, I became interested in the use, first of stem cells, and then gene therapy in the treatment of ophthalmic diseases. In September 2010 I wrote A Primer on the Use of Stem Cells in Ophthalmology, which was followed in November 2010 with my first writeup on the use of gene therapy in ophthalmology, The Use of Gene Therapy in Treating Retinitis Pigmentosa and Dry AMD. Since then, I have followed with more than 15 updates on stem cell treatments and more than a dozen for gene therapies.

In addition, I have put together comprehensive tables of the companies and institutions involved in both stem cells and gene therapies, the ophthalmic applications under evaluation, and data about the clinical trials underway and completed for both therapies. All of this information is now available online via my blog.

And, the Story Continues

I hope this overview has given you a glimpse into how I went from being a bench chemist to becoming an authoritative resource in the new technologies for treating ophthalmic diseases and conditions, starting at the front of the eye and working my way into the back of the eye.

For continual updates, please visit Irv Arons’ Journal and follow me on Twitter @iarons.


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