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Subspecialties Professional Development, Retina

What You Can Achieve… When You Believe in Yourself

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I’ve always been a geek. I grew up watching Star Trek, playing video games, learning how to code computer programs, and building my own telescopes. I went to medical school at the University of St. Andrews, then Guys and St. Thomas’ Hospitals. My father wanted me to become a cardiologist, but I had such a good time during my ophthalmology elective that I knew it was for me – I’d do ophthalmology or I would leave medicine. I did my PhD in Liverpool and my training at Moorfields Eye Hospital. From there, it’s been natural for me to combine my two passions – technology and ophthalmology.

I’ve always gone my own way and I’ve never given in to criticism. I am happy to listen – but I find that everybody just wants to look backward and find reasons why things can’t be done, rather than look forward and find ways to make them happen. There’s no such thing as “impossible!” I think underlying it all is the fact that I believe I can do this, and this confidence allows me to take calculated risks beyond other people’s comfort zones.

Setting up the London Eye Hospital

During my time at Moorfields, I conceived the idea of forming my own hospital. I feel like too many people just get through the day, do their job and go home – they’re not giving the best they can, and putting their heart into their work. I can’t believe I spent 25 years with the UK National Health Service (NHS), I really felt it drained me of my energy and enthusiasm; I left for good in 2011. It is a great organization with so many brilliant people but they aren’t always appreciated and sometimes treated badly by the people who run it.

I wanted to show people how it could be done, when all you had to do was what’s best for the patient based on your experience – without having to consider cost, internal politics, mainstream practice. That’s what I believe I’ve created with the London Eye Hospital (LEH) – the best technology, the best doctors, and the best service possible.

This may sound odd, but when I first set up LEH, I didn’t have a business plan, or even a strategy for breaking even. My main goal was to have the best technology and facilities I needed, and I did whatever it took to create my ideal practice. I simply wanted to create the best eye hospital in the world.  For years, it cost me huge amounts of money, but I kept funding it because I believed in what I was doing. Now the tide has turned – I own a very profitable organization that is still based on my original principles. Our patients appreciate that we don’t compromise on anything; we just offer the best treatment available anywhere in the world for their individual case using state-of-the-art equipment and facilities and the most experienced surgeons.

Innovation

I want to keep pushing boundaries, trying anything that is innovative and could benefit my patients. A lot of people bring new ideas to me now because I have a reputation for trying them – though I choose carefully; I have to believe in their potential. Some people may think we’re out on a limb, and I’ve drawn criticism from my colleagues, but time has already shown us that with some of the technologies we try, others follow. I remember purchasing my first first femtosecond cataract laser – the first one in the UK. I believed they were the future – and this year will see the first NHS hospital get one – so many of the things we do are just ahead of our time. We have things in our pipeline that sound like science fiction – but they are the future, and I believe the whole world will follow.

Ultimately, I think our dedication to innovation and trying the latest techniques and technologies means we can offer our patients a bespoke service – you need to try everything out there to find the best treatment. So that’s what we do – the best that can be done. We aim to provide every option there is, from the cheapest to the most expensive. And we aim to know our patients – their hobbies, their sports, how big their computer screens are, how close they sit to the television, how often they drive. We don’t consider value for money; we just offer the best possible treatment for that patient.

Developing iolAMD

I first had the idea for iolAMD in 2007. I’ve implanted a lot of different lenses at LEH, including telescopic ones for AMD. I was one of the first to implant the IOL-VIP, I believe I implanted the first IOL Revolution, and I’ve implanted hundreds of each – but both had issues. They were huge lenses, requiring a 7 or 8 mm capsulorhexis (which isn’t easy, even with a femtosecond laser), and the surgery took a long time. You have to put several things into the eye, then fix them together like Lego – it’s a nightmare. I felt that it was fundamentally flawed, and it was never going to take off. I can’t have been the only person in the world who thought there must be a better way to do this.

Dry AMD is the biggest untreated ophthalmic need in the world right now, and we had no suitable treatment options. Until stem cell therapy and other therapeutics arrive, our only options are optics and vitamin supplements. Therefore, creating the iolAMD was the greatest opportunity I could see – a lens based on a simple Galilean principle, updated for the 21st century. It’s foldable and can be inserted through a small incision. The total procedure, including cataract extraction, takes less than 10 minutes, and I believe it provides high-quality vision for patients with AMD.

I couldn’t believe no one else had done it yet – the market is huge, it’s phenomenal. I knew that creating something that can be done at the same time as a routine phaco procedure, without additional risk, that conveys extra benefits to patients with AMD would be huge. In potential revenue and sales, it’s billions of dollars.

Assembling a great team

I know a lot about optics, so I could model the lens myself, but I needed other people to fine-tune it for me and work on other aspects of developing it. I had learned from my experiences with the LEH and wanted to find the best people I could. I already knew Pablo Artal from our work with Calhoun Vision’s Light Adjustable Lens – and at first, he said it couldn’t be done. But I wouldn’t let it go because I knew it could, and eventually he gave in.

I met Rob Hill, who was a partner in the company that introduced the IOL-VIP to the UK and had a lot of knowledge about telescopic lenses. I knew I wanted him to work with me on iolAMD. So I built a great team, including scientists, managers and lawyers, but I wouldn’t take any investors. I didn’t want to lose control of what I was doing. The last thing I wanted was someone telling me what to do because they gave me the money to do it.

A £500,000 training exercise

Next, I needed to learn about the regulatory process, which is where the vitamins LEH Pharma sells come in – I wanted to make the best-quality evidence-based product in the world. Not only do they add to the AMD products available, but also they were a relatively cheap way to learn. To take a drug through regulatory processes can cost you tens of millions, but taking a vitamin through the regulatory and commercial processes costs maybe half a million, which is why I chose it. I learned so much with that half a million.

That’s why I set up LEH Pharma, opening with iolAMD and with a lot more ideas in the pipeline – although I can’t talk about them just yet! I plan to continue to develop my pharmaceutical business on a timeline that introduces new products every few years.

Believing in yourself

To anyone looking to bring their own innovation to market, I’d say: don’t listen to anybody. People will either pull it to bits, or tell you it’s amazing when it actually can’t be done. So many times, I’ve said I’m going to do something – like launch a range of vitamins, or build my hospital, or create a lens for AMD – and people simply didn’t believe me. Now that I’ve done it, people have to believe me.  I think if you have an idea and you really believe in it, go for it, no matter what anyone says. Worst case scenario, it won’t work out, but you’ll learn so much in the process. And next time, you’ll do even better.

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About the Author
Bobby Qureshi
Bobby Qureshi

Bobby Qureshi a hugely experienced ophthalmic surgeon who likes to be at the leading edge of eye surgery, utilizing the latest techniques and equipment at the London Eye Hospital, where he serves as its Medical Director. He was one of the first surgeons in the world to perform partial-thickness corneal endothelial transplantation, and the first ophthalmic surgeon in the UK to receive a femtosecond laser.

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