A favourable regulatory environment has ensured Australian ophthalmologists continued access to the latest ophthalmic laser technology. That privilege has become even greater after Meridian Medical Lasers signed a new distribution deal with Device Technologies Australia.

For more than a decade, a Swiss-made Nd:YAG laser has been the workhorse for comprehensive ophthalmologist Dr Jerry Vongphanit in his consulting room at Mona Vale Eye Centre in Sydney. But after 14 years of service, the system is being replaced to ensure the clinic can continue offering high level post-operative management of lens-based surgery and management of narrow anterior chamber angles.

Impressed with the quality construction and optics of his original system from Meridian Medical Lasers, Vongphanit has turned to the manufacturer again many years later seeking to implement its latest YAG laser technology – the MR Q (Micro-Ruptor and Q-switch) – into his busy clinic.

“I’ve found the new MR Q YAG laser is even easier to use. I can complete a capsulotomy within a minute, without the need for the capsulotomy contact lens for the majority of patients,” he says.

“The laser has a user-friendly interface and the power used to perform the treatment is more efficient. All this results in quicker turnover and happier patients. The variable offset feature also means I am less likely to pit the optic of the IOL with the newer laser. It’s also mounted on a mobile table, allowing easier treatment for patients who are wheelchair dependent.”

He adds: “A patient who had experienced the difference between the newer generation laser and older generation laser said the experience was much better with the newer laser. It was faster and we didn’t use a capsulotomy lens which made it less intimidating for them.”

Thun-headquartered Meridian has been an optical manufacturer since 1937, but the company turned heads on the ophthalmic laser scene in 1982 after teaming up with the renowned Professor Franz Fankhauser to release what it describes as the first commercially-available Nd:YAG laser, the Microruptor II, which is still used in medical offices today.

Since then – through proprietary innovations and acquisitions – it has gone on to develop a complete array of photo-disruptors (Nd:YAG), photo-coagulators (single-spot and multi-spot), and ablation lasers, offering therapeutic laser approaches for post-cataract, retinal disease, and glaucoma.

Over the years, Meridian laser technology has been available intermittently in Australia, with the oldest Meridian Nd:YAG in Australia (Microruptor V) installed in 1994 at the Sydney Eye Hospital where it continues to be used in supine treatments. There are several lasers more than 14 years old, and customers like Dr Vongphanit have reported being satisfied with their performance.

But since the beginning of 2022, the Merdian laser portfolio has become more widely available to Australian ophthalmologists, after the company signed a distribution deal with Device Technologies Australia (DTA). The agreement came after DTA discontinued the distribution of lasers from a competing manufacturer, opening the door for Meridian.

“We wanted to continue offering innovative laser solutions to the local ophthalmology market and Meridian with its Swiss-made laser technology was an ideal fit,” says Mr Angus Hatfield-Smith, product manager for ophthalmic diagnostics for DTA.

“So we worked out an agreement with Rick Behrens, Meridian Medical Lasers head of sales and marketing for Asia Pacific and Latin America, seeing DTA take over the sales and service for Australia and New Zealand with our team of around 40 staff focused on ophthalmology.”

The partnership has been a snug fit, with both Meridian and DTA having close ties with another Swiss medical device company, Haag-Streit, and the Meridian Meralis laser offering a good pairing combination with the Haag- Streit slit lamp.

Technology that appeals to eye doctors 

The YAG laser being installed at Mona Vale Eye Centre, where Dr Vongphanit consults, is part of Meridian’s latest MR Q family, consisting of stand-alone Nd:YAG lasers that can be coupled with single-spot retinal lasers such as the Merilas, described as a modern, solid, and reliable retinal laser, available in green and yellow wavelength.

Behrens, who has been with Meridian for more than two years after previously holding senior level sales roles at the Adelaide-based Ellex Medical Lasers (now part of Lumibird Group), says MR Q has become the company’s flagship device, replacing the Microruptor Nd:YAG.

And with the recent launch of the MR Q SLT at the European Society of Cataract and Refractive Surgeons in Milan in September 2022, this system is set to become its premier product.

“Our newest MR Q SLT will allow users to perform capsulotomies and SLT either on or off axis, at a competitive pricing. We want to help doctors to provide the right treatments without compromising the safety of their patients and preserving their financial position,” he says.

Behrens says Meridian has carved a reputation for providing reliable and solid lasers. They have the only approved Haag-Streit laser integration in the industry, meaning its Merilas laser becomes part of the slit-lamp through the slit lamp optical path, rather than an adaptor.

“We are sure this unique interaction with a leading slit lamp in Australia will be highly appealing to our Aussie doctors,” he says.

In addition to the laser technology itself, Behrens says there are many other features that make Meridian lasers an attractive option.

For example, its single-spot photocoagulators (Merilas range) are built using a robust aluminium housing, ensuring protection of the internal components, while the cavities are cooled by a propriety thermal electrical cooling system, eliminating the need for fans and noise, while remaining dust-free. To meet the strict quality requirements for multi-site photocoagulators, Meridian uses its own laser cavities encased in a robust and resistant material.

“We have some other unique features in our lasers,” Behrens adds.

“We can access each of our lasers remotely with minor help from the user. The distance in Australia complicates the work of the service engineers and the response may be delayed when the laser is in a remote location. Our remote service means customers, especially those away from the main cities, can be reassured Meridian and DTA will not leave them stranded without an immediate answer in the unlikely service event.

“Our Nd:YAG lasers also offer electronically controlled offset. One of the main complaints when performing a YAG treatment is lens pitting. This is often caused by the bad use of the offset. MR Q uses the relevant offset position for the capsulotomies and auto sets to ‘posterior 100’ as a default start, minimising the potential for human error.”

Many of these innovations are possible thanks to Meridian’s decision to vertically integrate with two European manufacturing facilities. This means its single-spot photocoagulators are made in Thun, Switzerland, where Meridian has its head office. The YAGs and multi-spot lasers are made in Slovenia, a high-tech country with significant German influence. And the multi-spot technology itself comes from Finland, a pioneer in pattern lasers.

According to Behrens, Meridian is also working on developing a SRT (selective retinal treatment) system at Bern University with leading Swiss and German partners. This, he says, may offer a breakthrough age-related macular degeneration treatment, with live feedback on the response of the retina and the laser energy being delivered.

“We are also developing a series of late generation cavities for our lasers,” he says.

Thanks to Australia’s regulatory environment, Behrens says local ophthalmologists have quick access to the technology, with laser selection driven by Medicare reimbursements that provide a privileged position among other countries.

The photodisruption market is dominated by dual action Nd:YAG, combined with SLT. He says this technology, launched in 2001 in Australia, has found its way as the “must have” laser platform in ophthalmology practices.

“The maturity and tenure of these lasers makes for a perfect replacement opportunity for newcomers,” he says.

“We know Australia is a tough market, I know first-hand the dominance of other brands. We are asking the doctors to give us the opportunity to bring a technically advanced device and allow themselves to treat with something new. My expectation from DTA is a strong commitment to the brand, and having a brand representative in the country should help their staff to engage with Meridian strongly.

“I have the utmost respect for DTA and its staff, I worked there, and I know how good they are when selling, servicing, and installing devices.”

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