The 2009 Congress of the European Society of Cataract and Refractive Surgeons and Presbyopia International 2009 Symposium took place against a backdrop of relative optimism within the refractive surgery industry. There are signs that the laser vision correction market may have hit bottom during the middle of 2009.

Millions of middle-aged and soon-to-be elderly people worldwide are running headlong into vision problems, and this looming patient pool is already beginning to steer the future course of physician practice and research and development dollars. The potential for huge rewards is certainly present for developers of safe, effective new therapies for disorders of the aging eye.

Presbyopia is causing a rapprochement between two distinct types of ophthalmic surgeons--the cataract surgeon implanting intraocular lenses in the elderly, and the refractive surgeon offering private-pay laser vision correction procedures to young adults. Bridging the gap is Refractec, the first company to ever get FDA approval for an ophthalmic surgery technology specifically for presbyopia. Refractec offers a non-cutting treatment that surgeons regard as a "starter treatment" that gets new kinds of patients into refractive surgery practices.

Visiogen Inc.'s Synchrony accommodating intraocular lens has dual optics, meaning that the ciliary muscles don't have to move it as much as other IOLs. The result, the company claims, is more accommodative power that translates into better vision at all distances. Like all IOL makers, Visiogen's point-of-entry will be cataract surgery, but it is eyeing the large presbyopia market.