DUBLIN, CA—In its first-ever Media Day on August 19, 2008, ophthalmology instruments manufacturer Carl Zeiss Meditec (CZM), a division of Carl Zeiss AG (Oberkochen, Germany), opened the doors of its Dublin, California manufacturing facility to the general media and selected city officials. Apparently, CZM wants to initiate a more open relationship with the media (and through the media, with its customers) regarding its comprehensive ophthalmology instrumentation portfolio. “Companies like Advanced Medical Optics (AMO; Santa Ana, CA) have been holding these media days for seven or eight years now,” said attendee Sean Henahan, editor at Eurotimes, one of the official publications of the European Society of Cataract & Refractive Surgeons (ESCRS; Dublin, Ireland). “I’m hoping to learn something today about CZM’s product portfolio going forward.”
Indeed, the company introduction, facility tour, and afternoon technology forum were all designed to provide the media with insight into the technology being poured into CZM’s products—nine of which are manufactured in the Dublin facility, which employs 700 people. In a video from James L. Taylor, CZM president, Taylor was careful to point out that his products were “NOT technology for technology’s sake,” but instead, “technology innovations that offer improved work flow in diagnostic applications.” He was proud to acknowledge that the roots of Zeiss go back 160 years and noted that nearly 10,000 optical coherence tomography (OCT) systems had been shipped by CZM in the last five to seven years—a testament to the industry’s embrace of the Zeiss brand.
To the question of CZM’s product portfolio going forward, Taylor offered some highlights in a video question and answer session that followed his introduction. Taylor expects a 20–40% drop this year in refractive procedures such as laser-assisted in-situ keratomileusis (LASIK). This procedure uses CZM’s femtosecond VisuMax laser, developed by IMRA America (Ann Arbor, MI; see www.laserfocusworld.com/articles/291338). To compete in the intraocular lens (IOL) market, despite the fact that AMO and Bausch & Lomb (Rochester, NY) are already well positioned here, CZM acquired Acri.Tec AG, a well-known player in the IOL market outside the U.S., and hopefully soon to be providing IOL services within the U.S. hinging on Food & Drug Administration (FDA) approval. Regarding photocoagulation research, CZM has initiated a three-year research project in this area, emphasizing that they don’t want another “me-too” product, but something entirely new.
On the financial side, Taylor noted that CZM was approaching $1 billion in revenue. An 8/14/08 CZM press release reported consolidated revenue of nearly $648 million dollars in the first nine months of 2007/2008 (1 October 2007 - 30 June 2008), corresponding to an increase of around 7% year-on-year. Important growth markets were the regions “Europe, Middle East, and Africa” and “Asia Pacific”, which more than counterbalanced the restrained sales trend in the U.S. market and the weak U.S. dollar. The release also reported that the “Ophthalmic Systems” strategic business unit accounted for almost half (45.9%) of CZM’s consolidated revenue for this period, even though the revenue of this unit dropped slightly. In its “Surgical Ophthalmology” strategic business unit CZM generated consolidated revenue of $84.7 million dollars (previous year: $56.7 million). The revenue increase of 49.4% was attributed to encouraging performance of new products and partly to the first-time consolidation of IOL and ophthalmic surgery specialist Acri.Tec.
During CZM Media Day, attendees from the City of Dublin (Mayor Janet Lockhart) and numerous publications including Eurotimes, Review of Ophthalmology (Newtown Square, PA), Ophthalmology Management (www.ophmanagement.com), and EyeNet magazine (San Francisco, CA; a publication of the American Academy of Ophthalmology), learned that the Dublin facility was opened in 1971 as the home of Humphrey Instruments, a medical instruments manufacturer that was acquired by Carl Zeiss AG in 1991. Amazingly, some of the original Humphrey Instruments personnel have worked for the company for 30 or more years.
In our facility tour by manufacturing manager Amer Singh, we learned that CZM is among the 10% of medical device manufacturers that use a paperless system when manufacturing its instruments. And considering that 7000 different instruments (with as many as 300–500 individual components per instrument) are manufactured each year with an estimated 70–80 pages of paper required to accompany each instrument, that is a tremendous paper savings and just one of the many “green” initiatives proudly undertaken at the facility. In addition to extensive office and research and development space, as well as the 20,000 square feet of manufacturing space with a class 100 optics assembly cleanroom and a main assembly line with feeder lines, the facility also houses an eye clinic for medical trials—an important consideration for speeding FDA approvals, which can have a typical five-year development cycle from product prototype to FDA approval.
Technology and instrumentation
The afternoon technology forum took a look at five primary focus areas at the CZM Dublin facility: microscopes, glaucoma instrumentation, IOL systems, OCT instruments, and data connectivity solutions. At each station, the presentations included testimonials from clinicians about the attributes of the equipment shown.
The OPMI Lumera microscope, used for guiding ophthalmic surgery such as detached retinas and cataract surgery (which is so common that by age 65, 30% of Americans have had cataracts), provides Stereo Coaxial Illumination along the path of its binocular vision for improved brightness, contrast, and depth of focus. CZM estimates that every 20 seconds, someone in the world has cataract surgery with a Zeiss microscope. “This may revolutionize cataract surgery,” said Dr. Howard Fine of Oregon Eye Associates in his testimonial. “I can see things I haven’t been able to see before doing cataract surgery.”
Glaucoma instrumentation includes the GDx scanning laser polarimeter to precisely monitor the progression of the disease in concert with other data, such as that provided by CZM’s OCT instruments and Humphrey eye perimeter instrument.
IOLMaster is the only non-contact instrument to measure the axial length of the eye (biometry) in preparation for IOL implants.
Perhaps the most impressive instrument among the group was the Cirrus HD-OCT, a spectral-domain, second-generation and higher-resolution version of an earlier time-domain Stratus OCT system from CZM. To date, the installed base of Stratus OCT is > 8000 systems and Visante OCT is > 1000, with Cirrus coming along at > 1000 instruments shipped. While Cirrus provides 27,000 scans per second at a 5 µm resolution (compared to 400 scans per second at a 10 µm resolution for Stratus), spectral domain technology is so new that its impact on clinical decision making is still being understood. Nonetheless, Cirrus can provide a 2 mm scan depth for the tissue at the back of the eye, and display a three-dimensional scan of any selected area, with an easy-to-use software interface.
The coordination of all this data from various instruments has long been a problem in clinical diagnostics: clinicians are required to gather the results of OCT, fundus imaging, and perimetry or polarimetry data to offer a course of treatment to patients. To make this process easier, CZM is offering its VISUPAC Star System as a connectivity solution to make it easier for various data sets from different instruments to be displayed, analyzed, and archived.
The CZM media day concluded with an overview of the community programs that CZM supports, including the Blind Babies Foundation of San Francisco and Vision 2020: The Right to Sight (www.v2020.org), a global initiative for the elimination of avoidable blindness, launched jointly by the World Health Organization (WHO) and the International Agency for the Prevention of Blindness (IAPB). Incredibly, a person goes blind every 5 seconds around the world, and eight out of ten people could be cured of blindness through better medical care and effective diagnosis. It’s easy to see why the CZM Dublin facility takes social commitment so seriously. Promotion of its products through events like this Media Day can only strengthen its global role in the ophthalmic industry.