B+L’s Chuck Hess is Looking to Change the Game in Ophthalmology

Click here to watch the video version of this podcast.

Chuck Hess, VP and general manager, US Surgical, Bausch + Lomb, says the partnership between clinicians and industry in ophthalmology has been a fruitful one. His experience in working with surgeons began early in his career, spending time in the operating room with what he calls “some of the greats in all of ophthalmic surgery,” and using his engineering background to develop surgical instrumentation to address their unmet need.

In this episode of the OIS Podcast, Hess tells host Firas Rahhal, MD, “That in and of itself is really the inspiration I have day in and day out. Just understanding the importance of the things that we do, to provide the machines, to design the new technologies and the techniques, to develop digital solutions for longer-term care, and really finding ways to change the game in this industry.”

Hess discusses B+L’s current activities, and also areas he’s excited about for the future, including:
• Improved analytical and digital tools.
• Hypersonics.
• Robotics.
• New technology for the company’s cloud-based Stellaris Elite system.
• Improving efficiency in workflow.

Hess predicts the next 10 years will be the most exciting in the company’s history. “I think the changes that we’re going to see in the next 10 years are going to dwarf the changes that I’ve seen in the past 37,” he says.

Click “play” to hear Chuck Hess talk about his passion to design, innovate, and bring great ideas to market!

Transcript:

Firas Rahhal: Thank you. Welcome back, everybody to the OIS Retina Podcast. This is Firas Rahhal. I’m a Partner at Retina Vitreous Associates Medical Group here in Los Angeles and also a Partner at ExSight Ventures in New York. And I’m delighted to have today as our guest, Chuck Hess, who’s a good friend of mine, we’ve known each other for a number of years through our cert retinal surgery travels together. Chuck is with B&L. Official title, and you can correct me if I’m wrong. Chuck, Vice President and General Manager of US Surgical for Bausch and Lomb, is that the correct title?

Chuck Hess: That’s correct. Yeah, thank you, thanks for having me. This is awesome, really appreciate it.

Firas Rahhal: I’ve been looking forward to it because I love to talk to the people who are providing us these great surgical techniques and technologies. And as you know, I am a retina surgeon, so I’m using this stuff. And I learned a lot when we talk with our friends and industry, I get a greater perspective. And I know the same is true for you guys. That’s how you learn what we need. And these dialogues have been going on in the operating room curbside together for decades and decades and now it’s getting a little more formalized with these podcasts and different kinds of electronic meetings. But we your industry and our specialty have been, you know compatible and in cahoots together in the OR for decades, is that your view of it?

Chuck Hess: We’ve, you know, we’ve had to be right. I mean, I think, you know, if you look at you know, the partnership between the clinicians and industry, it’s been really a fruitful relationship. And I’m, you know, I kind of go back in time in my career here in ophthalmology, starting out with a small company called stores, instruments and my days at stores were really more focused around product design. So I’m an engineer by training. And, you know, coming out of school I really took an opportunity to join this little company that really was involved in making world class microsurgical instruments. And I really had the opportunity, the privilege to work with a lot of the early names in microsurgical techniques and technology. And so I worked a lot in cataract, as well as retina, and a lot in refractive surgery. And so I worked with a lot of the great names across the board and all of these different specialties and, and that’s really where I learned how to partner with physicians to bring technology to market. And it was a fascinating time for me because I was in the operating rooms with, you know, some of the greats in all of pelvic surgery. And so learning that from, you know, surgeons across the country, really prepared me for really what I really had a passion to do. And that was to design to innovate, but also bring great ideas to the market. And they were all developed with surgeons really identifying an unmet need. And so I think that’s been kind of my training early on back in the mid-80s. When I got into ophthalmology.

Firas Rahhal: Yeah, I was. Thank you for that. I was, you know, I was looking over your bio to learn a little bit about the older history. I’ve known you recently, of course, and I saw that much like so many people in our business, that little stores company created a lot of careers that linger a long time in ophthalmology and particularly in retina, I guess I wasn’t, I shouldn’t have been surprised to know that you were at Wash U for your engineering. So a local guy in St. Louis, ends up hooking up with other local people in St. Louis, that must have been a lot of fun in those days.

Chuck Hess: It was a ton of fun. Yeah, I think, you know, as I look back, and, you know, some of the early days and in working, you know, coming out of school and you know, being a part of the local community, and then really finding this what I consider a gem, you know, in it was, you know, this company that, you know, was involved in helping physicians, you know, help patients see, and you know, what a very cool opportunity for someone younger and they’re young in their careers, it’s really getting an opportunity to be a part of something so impactful. And, you know, not only just from, you know, from what we do day in and day out to help our customers but really, to be in that operating room and see the work that the surgeons do, using the things that we designed to develop and create in our factories, but also having an opportunity to really see how they interact with their patients. So it was really fulfilling and I think that in and of itself, is really the inspiration that I have day in and day out, you know, doing what I do today, and, you know, just understanding the importance of the things that we do, you know, to provide the machines to design the new technologies and the techniques to develop digital solutions for, you know, longer term care, and really finding ways to change the game in this industry. And I think that’s where I really look at ophthalmology, engineering, research and development and all the things that we can do to help bring great solutions to the practice.

Firas Rahhal: You came out as an engineer, which makes a lot of sense for this. And I’m sure your original, you know, young guy, 27 years old, couldn’t wait to design some instruments. And I know, you’ve done that a lot. And I saw that you know, credited with hundreds of patents. And so that’s your engineering background. But you’ve now been there over 30 years, you’ve worn a lot of hats, you’ve been involved in marketing, sales, management, research and development, and now leadership, clearly, for the latter portions. Maybe you’re not as engineering as much, maybe you are, I guess I’m interested to know that, but what do you think about all these different roles? And how’s that progressed gradually, and led you to your current leadership role? And how are they different or similar between the different things you’ve done?

Chuck Hess: Yeah, you know, I’ve always loved the technical side, I think the technical training and development really is good. I mean, it teaches you really excellent analytical skills, and the ability to problem solve. And so, you know, a lot of what I learned in engineering school is really just that is the ability to be somewhat objective and look at problems in a unique way. And so as I embark upon my career, you know, engineering was really my background, but my love was business and just learning, you know, how to integrate both, you know, a technical background, in especially important in ophthalmology, where technology really drives innovation and change. And so it seemed like a pretty good fit for me. And so, you know, as I moved a little bit later in my career, and really tried to focus on how I can bring the technical side into my earlier responsibilities in marketing of our surgical devices, I was really excited to have the opportunity to move into capital equipment, marketing, and that’s where I had the first opportunity to really take a technology to market. So my first technology that I worked on, you know, in a more significant way, was the store’s premiere. And the premiere was really a workhorse of its kind. And it was the very first combined cataract and retina machine. And it really had a lot of great impact in the market, it was it grew pretty rapidly in market share, we were able to bring that technology into a lot of the teaching programs and really allow surgeons to get a good understanding of how that technology could actually help transform, not only the way we were doing surgery, but you know, for surgeons that were even on the cataract side converting from extra cap to phacoemulsification. It was really the early technology that I think helped drive some of that early change. So I look at, you know, at that the technical background that I had, coming out of engineering school, and really giving me an opportunity to really help talk to the physicians about what’s important to them as they’re treating their patients be able to talk about, you know, fluidics and you know, fluid dynamics and energy usage, etc. but also flip the conversation and talk about what’s important to your patients, and be able to really start to think about, you know, how we bring these technologies to market and what’s important as we’re trying to meet these unmet needs. And that’s really been really I think, a revelation for me is that you can really pair the technical side with the commercial side, they really come up with a really nice formula for leading not only an R&D project, but also leading a division of a company or really playing, you know, key role in leadership within our company. So that’s been kind of how I’ve been able to kind of bring all of those disciplines together in a big way.

Firas Rahhal: Yeah, I think the engineering background must help considerably whether you’re in the marketing end, the product development and or leadership, having that background in this space seems incredibly valuable to me. And it makes a lot of sense. Paul Hallen, who has a similar position to you, and I’m sure you know, Paul, I found out he also has an engineering background from here in Cal Poly. I’m in Los Angeles, that’s up in Central Coast. Actually, when I was on the Central Coast, I lived there for a short while, before I came here, Paul Gliebe, put one of those machines in a surgery center, I was building out the retina’s suite in around 2000, or 2001. And a few years later, we did some of the maiden voyages of the 25 gauge the original, and you guys were onto that early. And really, it was a massive advance, as we all know, now, I don’t think we recognize right then in 2003, or four, whenever we were starting to dabble in that just how big that was going to be.

Chuck Hess: It was huge, you know, I was early on in that, you know, when we were bringing in the Premier, you know, we had an opportunity to, you know, change the game and vitreous surgery up until that point, you know, the track dummies were all done at 2020-gauge, big cutters, large incisions grow out of these, you know, take back the conjunctiva. And you know, lo and behold, we had an opportunity to work with Jean Diwan up at the mad lab up in up at Wilmer, and remember, a lot of the early days when we would go to the mad lab with our engineers, and we would do a lot of research on you know, how we can get vitreous out of a 25 gauge, the tracheostomy cutter and this is back in the 90s. When, you know when all of this was kind of evolving. So stores at the time was really the early innovator with mad lab and bringing micro transconjunctival suture less retina surgery to the market. And that was a very exciting time for us because we were exploring not only how to get a vitreous cutter to be 25 gauge with all the technologies built into pneumatics. And the guillotine style cutter. But it was also important for us to really bring a whole contingent of the instrumentation like the fiber optic illuminators, and forceps and scissors and things of that nature. So we really were able to kind of pair the skill and the capability within our stores business, along with our stores instrument business with our store’s equipment business, and really to bring a more comprehensive package. So I think those were some of the really exciting early days in vitro surgery where we really advanced to this transconjunctival approach and, and it really has set the stage for all of the advances that we’ve seen over the years with some of the additional powder technology that we’ve been privileged to use.

Firas Rahhal: Yeah, definitely revolutionized everything we do in that era. And it was a lot of fun to be part of that on our side as well. I’m sure it was thrilling for you to be involved in the development of such an important technology. What about now, what’s your what and then I want to give you a chance, we’re gonna move on to all the cool stuff that you want to talk about what’s your day to day like now? You’re in a high leadership position, you still meet with doctors, I know because I’ve seen you. And you’re getting around, obviously, the pandemic held back some travel, but what’s your day to day like now? Who are you interacting with? How do you lead your team?

Chuck Hess: Sure, yeah. Well, you know, it’s interesting, I missed, you know, getting out there and working with physicians getting back in the OR. And so you know, the very first thing I did back in February was I took my very first plane trip in about 11 and a half months, and, you know, had an opportunity to go talk to another company about a business development opportunity. And so that was really my first opportunity to travel. But shortly thereafter, I put myself back into the OR I got into two or three operating rooms since the beginning of the year. So I like to do that. I like to go out and see what’s new, what we should be looking at talk to physicians learn about what’s making their you know, what’s exciting them and in the way they treat their patients. There’s a lot going on right now. You know, just from the news that we released, oh gosh, back in August of last year, which is Bausch and Lomb is preparing to spin out from Bausch Health. And so that’s been you know, a lot of great focus of the company. We’re going to be separating the eye care business out from the rest of the Bausch Health product portfolio. So we’ll have our surgical, our pharmaceutical, our vision care and our consumer products, all dedicated to eye surgery and eye procedures spun out from the rest of Bausch Health will become, you know, about a $3.7 – $3.8 billion eye only business publicly traded, and we’re excited about that, we think that, you know, there’s a lot of great potential within the market for probably the most comprehensive ophthalmology and eye care business and in the market. And so a lot of the work that we’re doing today is really preparing for that spin, but also managing the day-to-day activity. So, you know, I’ll have, you know, certainly, you know, a lot of, you know, conference calls by way of zoom or teams, we use teams with business, we do a lot of work with, you know, our product development teams, you know, we’ve been very focused on R&D all through the last few years really trying to kind of change the game. And, you know, over the next few years, we’ve got a lot of technology hitting the market, in retina and cataract as well as refractive surgery, in a big way. And so we’re really trying to balance a lot of what we’re doing from an internal development perspective, along with some of the BD activity just to make sure that we’ve got a good balance of technologies that certainly meet the unmet needs of our customers, but also give them the ability to leverage our entire portfolio in their surgical facilities. So a lot of neat things that we’re creating, and I can’t wait to tell you a little bit about some of the things that we have on the drawing board. But most importantly, it’s really all about the patient, and how we develop solutions so that our customers can provide really great integrated treatment to their patients.

Firas Rahhal: Yeah, anybody in this business, whether on your side of the table or mine, if you stay patient-focused, it really makes the goalposts pretty clear you and that I found that to be super true for the industry, people I have to, this is a credit to you and your industry. The goalpost is always very clear to the people on the industry side, something that I think the lay public may not know, they attribute those characteristics to doctors and nurses. And we should feel that way. And we do. But it’s also the key that motivates all the good people on your side of the table. I’ve seen that universally, in the 30 or so years, I’ve been around ophthalmology.

Chuck Hess: Yeah, I think it’s critical, you know, this partner, we look at it as a partnership, you know, we try to build, you know, the best possible technologies. And, you know, one of the things that, you know, that we really wanted to do was round out our retina portfolio. And so, oh gosh, about five, six years ago, Bausch and Lomb really identified, you know, an area of focus that we needed, you know, some more activity and then so Bausch, you know, to their credit, you know, allowed us to go out and look for a great technology company in Synergetics. And so we acquired that business. It was actually another St. Louis based this and lo and behold, we paired up our capital equipment, offering with the great instrumentation and accessories that Synergetics had within their instrument and in device business. And lo and behold really, it brought to the market a really great capability. Why because Synergetics had just such a beautiful line of microsurgical instruments as well as laser probes, fiber optic eliminators. And that was a bit of a gap that Bausch and Lomb had, you know, to be honest with you, we knew that we needed to strengthen our laser probe offering we had great lasers in our machines. But we really needed to provide a much broader range of technology. So the combination of Synergetics and Bausch and Lomb in our Stellaris Elite really, has been a really strong dynamic one two punch. It has given us an opportunity to get deeper into ORs. As our surgeons encounter the things that they need our technology with, we now have a great broad range of options for surgeons.

Firas Rahhal: Yeah, agree. Before I tee up some of the new stuff that you want to talk about that’s coming, maybe a quick couple of minutes on some of the recent stuff that’s going on in the surgical device area at BNL under your direction. You know, this Stellaris has been in advance over previous systems, some of which we just spoke about, and who, which I used and I’m familiar with, what things do you think in the last three to five years regarding the Stellaris and or other things like the bi-blade, dual port vitrectomy? What do you think that’s brought to the table as an advantage over some of the previous things? What are you most proud of, in these recent five years let’s say?

Chuck Hess: Well, gosh, you know, there’s been a lot of focus in the business, you know, during that period, for us, and one of the things that I think is really significant, you know, from what we did, you know, as we transition from, you know, the premier to the Millennium and then Stellaris, and then Stellaris Elite, you know, just a really a great launch about four years ago. And when we when we brought Stellaris Elite to the market, we really wanted to do a number of things, we wanted to be able to allow surgeons to really have a tool that they could easily expand and upgrade and update. And so that’s one of the reasons why we decided to take a number of key steps in that period, and really look to advance the state of the art as far as vitreous removal. And so, as you mentioned, the bi-blade cutter I think has been really the revolutionary technology to bring great efficiency to surgeons, as they’re approaching the eye and really finding ways that you know, through greater efficiency, greater flow out of the eye, be able to streamline these procedures and take, you know, what was potentially a more complex procedure but really give the surgeon ultimate control of how they’re approaching vitreous as well as shaving vitreous off the retina face. So all the things that we’re trying to do, you know, within this bi-blade technology really has given us an opportunity to help surgeons explore even deeper, you know, great utility with this technology. So viably technology was introduced on the floor asleep, you know, we also had an opportunity to increase the cut speed with this, this technology, so not only doubling with bi-blade but also increasing our cut rate from 5000 cars permitted on the Stellaris, to 7500 cars permitted on the Stellaris Elite and that was really, you know, a great advance for us as well. And then at the same time, pairing up all of the Synergetics laser probes and directional laser probes and all the illuminators coming out of the Synergetics line, all culminated as we wrote launched a Stellaris lead into the marketplace. And so now as we look forward, we’re really excited, we’ve got a number of key advancements that we’re working on as we speak, you know, we’re going to take that 7500 cuts, doubled the 15,000 cuts, and, and really push the envelope. And so we’ve got some new technology that will be embedded right into that Stellaris Elite System. That will increase the current rate well over 20,000 cuts per minute. So we’re excited, you know, to pair that up now again, with our bi-blade technology to really, you know, look at how we’re advancing, you know, the state of vitreous removal. We’re also you know, going to be implementing a new a couple of new updates, we know that surgeons really want ultimate control and how we deliver that is probably through a number of key aspects, but one of which is raising the aspiration limits to the machine as well. So, you know, providing surgeons with higher vacuum, as it pairs very nicely with like 27 gauge bi-blade cutting technology. And so those are some of the things that we’re going to be delivering here yet in the next six to nine months. So we’re excited to keep that platform going forward. And I’m really allowing surgeons who have invested in Stellaris Elite to really get the value of that product for a long return by keeping it fresh, and keeping it filled with great accessories and great capabilities. But the thing I’m actually most excited about is our work with Hypersonics. And you know that the hypersonic technology in in our test platform is really exciting and I’ll tell you it you know this advance really came again, when we launched the Stellaris Elite to the market a few years back in every machine that we sell actually is configured to drive that the test handpiece and so as we look to the future, and as we roll this technology out, in a big way, and in the future years, we’re excited that all of the Stellaris Elite units that we have out in the market are really ready to go. Now, we’re actually working on some new software and some new capability with the test technology. And that will be an easy software upgrade to the machine. And we’re prepared to do that very effectively. with, you know, with just simple service call. But what’s exciting about this technology is what we’re learning about it each and every day, you know, when we started upon this journey with Hypersonics, we were really actually looking for a new way to remove a cataract. And we approached the cataract in a pretty interesting way and realize that with this small aperture probe, we were actually able to impact the vitreous in a pretty significant way. And it inspired us to really continue on this journey to understand more about how we can leverage Hypersonics. And in rapid fluid flow along with physical cutting, to really make an efficient vitreous cutter. So that’s really what we’ve been doing really over the last Oh gosh, 10 years or so really taking that concept of, hey, I want to remove a lens more effectively to let’s talk about how do we expand upon our capabilities in the vitreous space? So we’re really excited about Hypersonics we think that, you know, this technology has a lot of legs. But I think we still don’t know everything we need to know about it. And I you know, I keep going back to the days of you know, how long did it take us to really perfect the pneumatic guillotine cutter, it took us a long time. So you know, we’re making great strides and vitreous removal, using this technology, but what we’re really excited about is how it actually impacts other tissues within the eye like drop lenses, for instance, you know, we’ve been we’ve been seeing a lot of clinical work where we’re actually able to take a drop lens a very efficiently so it becomes now a great tool for the vitreous surgeons really think about, you know, expanding their horizon in approaching vitreous surgery and complex cases a lot more effectively. So we’re excited about where it’s headed, we’re still working on optimizing settings and in power capabilities and fluid dynamics, etc. But we believe we’re making really good progress where we’re in, in the clinic and eyes. And we’re doing that in a limited basis just to learn a lot more about the technology before we bring it out to the masses. And as you can imagine, you know, as you’re bringing new probes and new technologies to the market, we really need to be able to prepare our surgeons to really harness this technology to their advantage. And that’s what the work that we’re doing today with this technology.

Firas Rahhal: I’m fascinated by the ultrasound idea and you’re calling it hypersonic. That makes a lot of sense to me. I’ve been around ultrasound, since my residency kind of intermittently, Jack Coleman, our Chairman at Cornell, at the time, is a brilliant researcher and helped develop you know, I’ve found that ultrasound and he was developing therapeutic use of ultrasound, as you are talking about now, not just diagnostic, and it’s making a little bit of a comeback. I’ve heard some startups considering, you know, using certain frequency ultrasound to treat glaucoma by I guess pulverizing in a certain way, you know, destruction of ciliary processes, etc. So it always made sense to me that we probably were underutilizing this physical technique or this physical energy of ultrasound and neuron to this now. So how do you see this fitting in? I know there’s still a lot of unknown and I applaud you for approaching this cautiously and with prudence not to just sort of jump in and let’s do everything with it. But how do you see it fitting in? Do you see a future where ultrasonic, and I don’t know if the right word is pulverize or phaco or whatever of removal of vitreous? Can that be the principal way we could remove vitreous at some point?

Chuck Hess: We’re convinced that this is a technology that, you know, we need to put a lot more energy into. And I think, you know, just what we’ve seen today and the early and they’re only go, you know, convinces us that we’re headed down the right path. And so, you know, today, what we’re working on, as I mentioned, is, you know, a little bit of the setting side, you know, really trying to balance, aspiration and energy. The other thing that we’re doing too, is we’re exploring new port configurations as well, because this technology really does rely on fluid flow, but it also relies on the impact of different port configurations on the vitreous. So it’s a combination of, you know, fine aspiration, control, as well as cutting efficiency. And so we believe that, you know, with these different import configurations, we can probably optimize the technology for different tissue of, you know, impact and so, is it a viable vitreous aspirator? Absolutely, we’ve seen that with, with the work that we’ve already done, can we remove lens material? Absolutely, we’ve done that in the clinic, as well, and in the OR and so. So we’re convinced that not only is this you know, going to be, you know, a viable technology for the vitreous surgeon, we think that it’s going to add, you know, increased capability for, you know, for your procedure. So, in other words, if you’re approaching a, you know, a drop nucleus, you know, the last thing you really want to do is pull out a frag handpiece, but you do it because you have to have to, right, and so I think, you know, that’s where we’re excited about this is, you know, we can go right through a, a trocar and cannula, and effectively remove a lens without having to pull the trocar out and enlarge the wounds. And so we think that the efficiency of this technology will really play very nicely in the, in the individually so far of the future. And we also think that, you know, as we kind of look forward into your point a few minutes ago, you know, where else can we use and leverage Hypersonics in ophthalmology, and we think that there’s probably a number of opportunities down the road that we haven’t even been able to explore yet, because we really want to get this vitreous technology out into the market.

Firas Rahhal: Yeah, I imagine there’s a lot of prep work for all of this, when we first started doing phacoemulsification for cataract, there was a lot of concern for good reason about corneal endothelium. And we definitely saw some disasters around too much ultrasound adjacent to the corneal endothelial the cataract surgeons are now quite expert in the technology is so much better. Similarly, I assume there’s testing that’s already been done and maybe ongoing? how close can you get to the retina with a hypersonic probe safely, maybe you can even use it to do retina manipulations, maybe it’s safer around the retina?

Chuck Hess:Well, we, you know, we did a lot of homework in that area. And, you know, a few years back, we worked with a surgeon over in Europe, Polish Ganga, and he did a lot of the histopathology work that we needed to really validate the technology and allowed us to get a clearance from the FDA for this technology. And so I think, you know, we’re we’ve got a lot of the basic science down, I think we’re, you know, we’re really comfortable with this is, you know, as a potential replacement for pneumatics. But, you know, let’s, you know, but we also want to make sure that, you know, the things that we’re doing, you know, with respect to harnessing all of the energy that’s coming from these probes and managing fluidics really is giving us do the proper, the proper response to the eye. And I think that’s the most important thing is, you know, what you don’t want is you don’t want a technology that slows you down and delays the procedure, but you want something efficient, and that can really deliver the performance that you need in order to take the best care for the patients. And that’s really our focus at this point is really providing, you know, a viable alternative to pneumatics and that’s the focus of the project at this point.

Firas Rahhal:Great, great, thank you. What about other technologies I know you have a personal interest in the company obviously has an interest in intelligence and bringing, I won’t use the word artificial intelligence but in let’s call it in the generic intelligence technologies. To the OR, and maybe to the office, you had, there’s something at your company referred to as eyeTELLIGENCE. What can you tell us about that? And what’s going to be the new frontier there that you can share with us?

Chuck Hess: Absolutely, yeah. So. So one of the things that we did when we launched the Stellaris Elite is we connected it to the cloud. And we did that for a number of reasons. We believe that was really a great technology to have in the operating room. And it was actually the very first ophthalmic surgical device connected to the cloud. And why did we do that? Well, we wanted to do a number of things, we wanted to provide a tool and a technology that we could leverage, you know, to gather information about the machine and how it’s performing. And so a lot of what we thought about, you know, being able to connect to these machines is how do you gather information about the machine and in its utilization, primarily, because we wanted to be able to identify when problems arise that, you know, we could preemptively go into service machines and be able to keep your uptime as reliable as possible, you know, the last thing you want is a machine that breaks down and you have to cancel a day a surgical cases. So we felt as if we could capture information from that machine, you know, scan the subsystems and understand when something was going to fail, we could dispatch our technical teams before you ever had a catastrophic failure. So that was job number one, the other job that we wanted to do is really provide some convenience to the surgeon, as they’re going from hospital room to hospital room, OR to OR whether they’re operating in one facility or facilities across town, we wanted to be able to allow you to bring in your information, whichever machine you’re operating at, and be able to have all of your settings inherent in the machine with it, without having to have the rep come in and reprogram each and every one of your machines across town. And so we were able to do that where we’re able to use eyeTELLIGENCE to store your settings, your own personal settings in the cloud, and then be able to bring those down into every Stellaris Elite machine that’s in the marketplace. And so that was job number two. And then we really wanted to build a platform for data management and so, so that gave us the opportunity to do that. So the data that we’re collecting about your surgical procedure, we have stored, and we’re building applications now that will allow you to gain access to that data and be able to use it as you’re analyzing their surgical procedures or your techniques. And really trying to understand, you know, the trends in your cases, I think the other thing that we were really excited about is, how could that parlay into a better relationship with the teaching institutions, as well, as we all know, that residents, you know, have to do go through a series of surgical procedures in their training. And that’s, that was really, I think, the best opportunity for us to really think about how can we provide valuable information back to the doctor that will help them in their training and their development. So those were some of the other early needs within this area. But I think we’re looking at this in a much bigger way. And we really look at really a number of key workstreams within the business of ophthalmology that I think we can add value using this eyeTELLIGENCE data platform. I think that’s really exciting for ophthalmology, because, you know, it’s not only about, you know what the machine is telling us, but it’s really about what the machine is telling you, and how do we connect other technology to this ecosystem that provides value to the surgeon. And so that’s really our focus at this point, is really identifying those future technologies that we can bring into this eyeTELLIGENCE ecosystem and provide surgeons with a great planning tools. And so we think that you know, in the in the world of data now going forward, that really is truly the value statement. And so it’s all about how we care for the patient. It’s how we transmit information from the office to the OR it’s how we provide you with the tools necessary to make the right decisions upon what technologies do I need to be pulling for that next case, whether it be a laser pro for one case, or the test probe for another case. And so, these are some of the things that we’re really trying to work on is workflows and workstreams. that allow greater efficiency, you know, better predictability and analytics that allow us to really perfect our techniques. And also looking at the back office, management of the operating room as well. And how we can add value to things like product replenishment supplies that are used during a case could be automatically ordered those types of things that I think we can really leverage data now in a bigger way to provide increased value and increased capability. So I think this is we’re early still very early in the development of these, these analytical tools and these digital tools for, you know, for efficiency for driving efficiency and greater, greater care. But we’re excited about the future, we’re well vested and invested in this. And I think we’re just really kind of tipping the iceberg as it relates to you know, how we bring technology to the market, and really leverage data along with the devices to really deliver, you know, a great, a great combination of technology for the future OR, that we’re all excited to get into.

Firas Rahhal: That’s a great segue for me, because there’s a topic, I wanted to ask you about. And I think this leads right into it. So we have the context of this great high-level real-time data analysis and data availability to the surgeon, the doctor in the office, but let’s speak about the OR for a minute. And all these precision tools that are constantly evolving and getting better. And the other part of the constellation that I’m sure you’re aware of, is that these biologic treatments that are coming now stem cell implantation, and gene therapies and things like that are going to require both, you know, precision tools and possibly real time data feed back to the doctor, how do you see that fitting in and out throwing a wrench in this is hypothetical, of course, but there’s a lot of talk of it. And there’s some companies looking at it, robotics as part of this triad of things. At the same time, how is your company, I’m sure thought about this? And what is your view of that in the future? And how long?

Chuck Hess: I’ll tell you; I think this is probably the most exciting area, and I’ve never met a three-arm surgeon. So you know, anytime where we can add value to the surgical procedure, you know, through something like robotics. And it’s really exciting. I, you know, I think we’ve seen some of the early renditions of surgical technology, controlled by robotics, I think I think there’s a lot of opportunity in the future, as it relates to, you know, some of the things that you just talked about, which I think is really important. We look at gene therapy, and all the things that we’re doing separately, as an opportunity for us to really add value. And so a lot of a lot of what we’ve been doing really lately is working with some of the some of the bigger companies that are implementing, you know, sub retinal drugs and gene therapy. And what we found is that, you know, they’re great on the drug side, they’re not very good on the device side. And so what we’re trying to do is bring our capability within our Synergetics portfolio, and within our surgical equipment portfolio to really think about how we can add value there. So, we’ve actually partnered our Synergetics development team, along with a couple of the companies that are out there, really looking at how we adapt some of our instrumentation to work in that space. But I think the natural progression is, is not only, you know, getting the material under the retina, but really understanding how much are we delivering? And how do we how do we gauge, you know, the volume metric analysis as well. So I think there’s a lot of exciting things out there. I do think that, you know, I do think that robotics will tie very nicely to some of this. I do also believe that visualization is, you know, it’s an interesting area as well. And, you know, in the combination of, you know, of precision instrumentation, along with the robotics, and the visualization, I think really give us any imaging technology as well really give us the opportunity to really accelerate into the future. So, we’re excited about where all this is headed. We think that the digitization of the surgical procedure and all the things that we’re able to collect now to plan a procedure and execute the procedure and follow these patients longer term, you know, combined with some of these advanced treatments is an exciting area. And we’re very excited, you know, from our perspective to really get into some of those futuristic technologies as time goes on.

Firas Rahhal: Yeah, I’m glad you mentioned that visualization can never be overestimated in ophthalmology, but obviously, particularly in the retina surgery space, it’s improved so much in the last 20 years, but there’s still a lot of room for improvement. And I’m glad that, you know, the companies are thinking about that, as surgeons, it’s always one of our greatest challenges is to achieve high quality visualization for every step in the case. And it’s not always there, and there’s still room for improvement. What about in the office, Chuck? Are you guys looking at some of these data analysis and door precision technologies for office-based work in ophthalmology as well?

Chuck Hess: You know, it’s interesting, we were, we’re pretty, you know, I think, you know, if this point, if you consider the office, and, you know, it’s an important environment for the physician, right, it’s where you do a bulk of your work related to patient care, and injections, etc. And so, you know, for us, you know, we have a strong interest in the office, we think that the office is really where a lot of the decisions are made, as far as how we treat the patients, you know, in the OR, etc. So, one of the things that, you know, we’re starting to see a little bit more of, especially on the cataract side, not so much on the retina piece, but I’m not, I’m kind of keeping a close eye on how all of this is evolving is, you know, we are hearing about surgeons who are, you know, now starting to think about, you know, how do they execute some of these procedures in their office, and I don’t know, where it’s all going to be honest with you. You know, from our perspective, we’re at we’re an equipment and device and drug company, and I think, you know, from our perspective, you know, we want to be mindful of the need for, you know, for supporting the doctor and the patient. And so, so we’ve been really looking at, you know, how do we improve our performance in the OR, whether it be in the hospital, or the surgery center, and maybe someday in the doctor’s office, you know, from a surgical intervention perspective, if that’s where the doctor believes that their best work can be done, but I think efficiency is really important. And, you know, you look at, you know, the time that it takes to go down the street to the hospital or the surgery center, and, you know, get your cases done, and then come back to the office and have to do another half day of seeing patients, etc. So, I think, you know, the objective really is how do we make all of these much more effective and much more efficient. And so, as we look to the future, we’re looking at improving efficiencies, we talked a little bit about Hypersonics, and bi-blade technology, how do we provide the instrumentation that can make us efficient, and ultimately, how do we provide the information to the doctor to really become that much more effective, and how they execute their patient care. So all of those things are on the table, you know, we continue to look at, you know, where the market is headed. The interesting thing for us too, is that because we’re a global supplier, you know, we’re addressing a lot of regional needs around the globe. So what we’re doing in Europe is so significantly different than say what we’re doing in Asia, for instance, and, you know, a lot different from what we’re doing here in the US as well, so but the benefit that we have is really, we have a really good strong global organization between ourselves here in the US, our team outside of the US, we all contribute to our direction in our 10 year horizon planning that we do each and every year. And we really take a look close look at where we think you know, it’s the old saying about, you know, you skate where the puck is going to be. And I think that’s really, you know, our perspective is we want to make sure that, you know, the things that we bring to market really, truly add value to you as the clinician and be able to support you know, excellent patient care. And, you know, I think those are some of the things that we always gauge we use that as our ruler, to gauge where we put our money, our money is precious, our time is precious, but our efforts are really dedicated to patient care. It really supporting the eye care community. And so I think those are all the things that we really tried to pull together to deliver the technology that we believe is you know, for the future is really set in excellent patient care. So whether we want to work in the office, the hospital, the ASC, the OR, the office environment, we want to be there, we want to support our customers. We don’t want to get so broad that we get too distracted. But we really want to develop and deliver a great, great care for our patients. And however we can manifest that we’re absolutely committed to doing. And that’s really one of the reasons why as you look at some of the announcements that we’ve made here, really over the last year, you know, really thinking about how do we take our surgical expertise and combine it with our pharmaceutical division to really bring things together. And so, you know, we announced, you know, our recently, you know, a biosimilar that we’re going to be bringing to the market here to lose centers, we also announced, you know, our acquisition of some of the ophthalmology assets of Allegro. And we’re continuing to look at, you know, good, strong, you know, retinal technologies in the drug space. And we believe that because we’re in retina in a big way, and surgical as well as pharma, we can bring those technologies together and really continue to deliver great value and great options for the space here in the time to come.

Firas Rahhal: One final thing, before we run at a time, you mentioned in this context, the spinning out of the eye care portion of Bausch and I think that makes a lot of sense that that would allow you as a company to be laser focused. And I’m sure that’s part of the impetus for that. What about you? Personally, you’ve done a lot there, I have no reason to think you’re not gonna be there for the rest of your career. But what personal hurdles would you still like to do within the company or within the science of ophthalmology?

Chuck Hess: Well, I’ll tell you, you know, we have had just a tremendous amount of support from the company in our surgical business. And we’ve been very blessed by a significant amount of investment in allowing us to go execute a really strong strategic plan. We’ve got a great plan over the next 10 years, to have significant growth in our business, to break into new markets, with new technologies, and really reinvigorate some of our key brands within the marketplace. So I look at the next 10 years as probably the most exciting in the company’s history. And I’m just excited and tickled to be a part of that vision and in the opportunities that my senior leadership has given us, Joe Papa, Sam Eldessouky, Joe Gordon, the President of Bausch and Lomb has really been 110% supportive of our vision for where this business can go. And so I feel like, my job isn’t done until I deliver that 10-year plan. And so, so that’s what this is gonna be, I think, you know, just looking at, you know, where we can get to with Bausch and Lomb in this market, you know, doing the things that we’re doing partnering with surgeons, partnering with the healthcare community, bringing new technologies is incredibly exciting. And I think the changes that we’re going to see in the next 10 years are going to dwarf the changes that I’ve seen in the past 37. So I’m really excited to be a part of it and, and really enthusiastic about where we’re going and having an opportunity to work with more surgeons in the future. So, so excited to be a part of that, and I’m really focused on the future.

Firas Rahhal: Thank you. Chuck Hess, Vice President General Manager, again of US Surgical for Bausch and Lomb and my friend and a friend to all of us in the Retina’s space. Thanks, Chuck for coming on. That was enlightening.

Chuck Hess: Thank you Firas. I really appreciate the opportunity.

Firas Rahhal: My pleasure.