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Homer’s Code: “A (Brown) Eye for a (Blue) Eye” – Interview with Strōma Medical Founder

November 17th, 2011 Shiv Gaglani Exclusive, News, Ophthalmology

From Ancient Egypt’s jade-green Eye of Horus to Van Morrison’s “Brown Eyed Girl,” few anatomical features have captivated artists, scientists, and the general public as much as eye color. Like that of the skin, the color of the eye is determined by the presence or absence of pigments such as melanin. Eyes are brown or black when they have melanin in the stroma of the iris; blue or green when they do not. Traditionally, the only way for one to “change” the color of their irises has been with masking colored contacts. That may soon change.

A Californian company called Strōma Medical  recently made headlines after announcing that it could use lasers to, in essence, vaporize iris pigment away and thus change eye color. They have been focusing on the brown-eye-to-blue-eye transition by ablating melanin in the stroma (hence the company name). We had the opportunity to interview the company founder, Gregg Homer, about the technology. If it works and receives approval, this author predicts that it may not be long until we see people with intentional heterochromia (different colored eyes) or iris tattoos.

 

Shiv Gaglani, Medgadget: This is an exciting technology, as evidenced by the widespread coverage you’ve received recently. Are there ways to change iris color not only from brown to blue but to green or other colors? How about blue to brown with pigment deposition?

Gregg Homer: Our first project has been changing brown to blue because that change is the most straight-forward.  We have changed green to blue, but it involves an extra step, so we will wait a beat to roll that out.  Brown to green is more complicated.  We’ve figured it out on paper, but it will require separate studies before we will feel comfortable releasing it.

 

Medgadget: Do you have any photos of the invention or results (e.g. studies or before/after photos) you have from your trials?

Homer: Here are a couple of photos:

1. An image of the current Strōma laser (side).  This is the clinical version.  The commercial version will be similar in format, but a way cooler design.

2. Partial Pigment Loss 1-2 (top and bottom): These are high-quality images of irises with partial pigment loss.  They are helpful because they show the blue eye that exists under all brown eyes.  These are not Strōma patient photos.

Unfortunately, HIPAA and our patient privacy agreements preclude us from providing you with actual clinical photos.  They are virtually identical to the attached Partial Pigment Loss 1-2 images.  The only difference is that we have removed the pigment from an elliptical area at the superior iris (i.e., at 12:00) so that the treated area would be covered by the patient’s eyelid after the procedure (for both cosmetics and safety).  We have not yet treated an entire iris.  That will be the next stage of our research.

 

Medgadget: According to your 2004 patent (Techniques for Alteration of Iris Pigment), the wavelength for pigment ablation may range 50-2000 nm. What wavelength(s) are you using and how did you decide to focus (pun intended) on them?

Homer: We use a combination of wavelengths.  The specific wavelengths, as well as all other treatments parameters (e.g., pulse width, spot size, spot separation, beam divergence, etc.) are proprietary trade secrets.  We do not even reveal this information to our board members or investors.

Medgadget: How do you respond to safety concerns that have been brought up by ophthalmologists in prior coverage of your technology (e.g. infection, double vision, etc)?

Homer: Infection is not a serious risk because the procedure is entirely non-invasive, i.e., there are no incisions or injections of any kind.  In fact, there is no contact whatsoever with the patient’s eye.

Double vision is also unrealistic–as is any affect on the patient’s vision–because the Strōma laser treats only the iris.  The beam does not enter the pupil or treat any portion of the inside of the eye, which is where the nerves affecting vision are located.

There are, however, risks for which we have and will continue to test extensively.  We were concerned about pigmentary glaucoma right from the start, so it was the first condition for which we tested.  Thus far, it has not proven to be a problem in either animals or humans.  The precipitating condition, known as “pigmentary dispersion syndrome,” arises from abrasion of the pigment of the iris epithelium, located at the back of the iris.  This pigment is much thicker than the pigment on the front of the iris, and the abrasion causes this thicker pigment to be dislodged in relatively large pieces.  These pieces travel to the front edge of the iris, where they become trapped in the trabecular meshwork covering the Schlemm’s canal, thereby reducing fluid outflow and increase the pressure within the eye, known as intraocular pressure or “IOP.”  It is believed that this increase in IOP can cause glaucoma, a condition that begins with the gradual loss of peripheral vision.

In the case of Strōma, the pigment layer covering the front of the iris is far thinner than the pigment layer at the rear of the iris.  In addition, the pigment is removed by the natural tissue elimination process initiated by laser exposure, rather than by direct abrasion.  As a result, the pigment is released gradually in microscopic particles that are small enough to pass easily through the trabecular meshwork and Schlemm’s canal.

In fact, one of the most successful treatments for pigmentary glaucoma is selective laser trabeculoplasty or “SLT,” whereby a laser is used to treat the epithelial pigment trapped in the trabecular meshwork.  The treatment breaks the pigment into far smaller particles so that they can pass more easily through the trabecular meshwork.

Thus far, the Strōma procedure has only undergone limited study in humans and has proven completely safe.  We plan to treat 100 patients in four countries and follow them for a full year.  We will not release the product until we are satisfied that it is safe.  My personal moral touchstone is, “If I wouldn’t allow my daughter to do it, I have no business releasing it to the public.”

 

Medgadget: How did you get the idea for this technology?

Homer: I’m an inventor, not a medical doctor.  (My doctorate is in biology.)  So I am always trying to figure out how to do new things (or old things in new ways).  In the mid 1990s, I took an interest in lasers.  A friend of mine is a laser dermatologist, and one day over lunch, I was picking his brain about how lasers remove dermal pigment.  On the way home, I began to wonder what effect lasers could have on iris pigment.  I began researching eye color.  Only one paper had been written on the subject, and that was from the mind-1980s.  I concluded that lasers could permanently change eye color.

 

Medgadget: Does Strōma Medical have any other procedures or products in the pipeline?

Homer: Strōma does not.  It was formed solely to launch the eye color change technology.  But I have several other patents in the fields of medical devices, media, communications, and software.
Medgadget: Many of our readers are currently involved with, or interested in starting, medical technology companies. Can you please describe your initial interest and background in medical technology?

Gregg Homer: I’ve had several careers.  I began as a studio musician while in high school in the late 1960s/early 1970s.  In college, I built and ran a chain of clothing stores.  I then spent a year immersed in an MA program in creative writing.  Next, I went to law school and spent the next 20 years practicing entertainment law in Los Angeles.  In the mid-1990s, I accepted a teaching position at Stanford Law School (from which I had graduated).  I took an interest in science for the first time in my life.  I came to biology because I was fascinated with evolutionary biology–specifically, the evolution of the neural system and how it has affected the formation of social rules.  A mentor of mine–the renowned social psychologist Phil Zimbardo, PhD–convinced me that my work in this area was important and that I should write a dissertation on the subject and complete my doctorate at Stanford, so I did.  (I also I spent a year in an MA program in economics so I could use game theoretic modeling to prove my theories of social rule formation.)  While at Stanford, I was infected by the love of innovation and entrepreneurship, and I began inventing.  So I guess–to quote Joseph Campbell–I just “followed my bliss.”

 

Medgadget: Wonderful. Thank you for taking the time to speak with us – we look forward to keeping an eye out (again, pun intended) for future developments from your company.

Gregg Homer: My pleasure!

Shiv Gaglani

Shiv Gaglani is an MD/MBA candidate at the Johns Hopkins School of Medicine and Harvard Business School. In addition to curating the Smartphone Physical (www.smartphonephysical.org), he also contributes regularly to CardioSource World News and Emergency Physicians Monthly. He is interested in developing scalable, tech-based solutions for medicine and education; to this end he is the co-founder of the medical education tech start-up, Osmosis (www.osmosis.org).  More about Shiv: http://about.me/sgaglani

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