This page contains a Flash digital edition of a book.
Medical Manufacturing


vision is better than the natural lens before it became diseased. Appasamy produces 300,000 lenses a month, as well as the disposable syringes used to inject them into the eye, and an enormous range of other instruments and equipment used in eye clinics and hospitals. Te company also has an office and lens manufacturing facility in New York City—Ellis Opthal- mics, near JFK airport—the output from which is almost all imported back into India. “Indian doctors want US-made, imported lenses,” says Ravichandran, “even though they cost more.”


Innovation Over Importing Other than lenses, almost all of the company’s milestone


products and innovations over the years have been those that met a local need at a cost far lower than imported equip- ment. Formed 33 years ago, the company is still chaired by its founder, P. S. N. Appasamy. In the 1970s, he worked in the US for a contact lens manufacturer, and soon began his own company making a low-cost product to freeze the nucleus of an eye, ready for removal. At that time, a European company made the only similar machine capable of doing the same job. Te European machine was too expensive for doctors in India. Mr. Appasamy simplified the design, and was able to sell a more suitable product for a far lower price. Te new machine became very popular in India, and made cataract removal a


intraocular lens, it sometimes happens that the capsular bag becomes thicker and “frosted” behind the lens, causing light to scatter before it reaches the retina. To alleviate the problem, a laser is used to perforate the opaque area of the capsule, allow- ing light to penetrate more readily. For 20 years, German optical company Carl Zeiss made the only YAG laser available in India, until Appassamy designed and built a lower-cost version. “Te YAG laser is another Appasamy success story,” says


Ravichandran. “Carl Zeiss only ever sold around 1600 YAG lasers. In the eight years since we launched our product, we have sold 1000 examples.” Appasamy counts more than 10,000 Indian doctors as


its customers, all of whom are looking for lower-cost and simpler alternatives to imported products, such as ultrasound machines that used to cost $200,000–$300,000, but that Ap- pasamy now supplies for just $10,000. Te company’s less-invasive system for replacing intraocular


lenses eliminates the need for surgical stitches, since the hole made to insert the lens is smaller than 5 mm. Te replace- ment lens is furled and injected into the eye, where it unfolds, like a ship in a bottle. By eliminating the need for stitches, the procedure is quicker and easier, and there’s less chance that the eye will deform and lose its shape. As well as making the lenses, Appasamy also makes the single-use syringes, whose molds are machined on a Haas VF-2 Super Speed.


Appasamy customers include more than 10,000 Indian doctors, all of whom are looking for lower-cost and simpler alternatives to imported products.


much more viable procedure, particularly for peripatetic doc- tors taking their services to patients in rural and remote areas. Appasamy employs more than 2500 people: 1380 at its


Puducherry factory, with most of the others based at plants in Calcutta, Chennai, and Delhi. Te company’s current annual sales are more than (US) $2 billion, and many of its mainstay products are made on a line of 20 Haas CNC machine tools at its Puducherry factory. A single Haas Mini Mill, 11 VF-1 vertical machining


centers, and eight SL-10 turning centers make, between them, the parts for 1800 different surgical instruments and pieces of equipment in the Appasamy catalog; products such as micro- scopes and slit-lamps used in clinics and operating theaters, and tonometers for testing the pressure of an eyeball. “Te tonometer is one of our best-selling products, and is


our own design,” says P. Prakash, deputy manager CNC. “All of its 45 different parts are made on the Haas Mini Mill. We make 150 finished units a month.” Another successful, home-grown Appasamy product is a YAG laser. Aſter a cataract is removed and replaced with an


48 Medical Manufacturing 2013 Te Appasamy Slit Lamp alone has 60 components—some


turned, some milled—made from aluminium, stainless and brass. Te company completes 350 assemblies a month, and aims to increase production to 500 a month. Te optical assem- bly for the operating microscope is made on the Haas VF-1s. Tere are two models of the finished product: one with continu- ous magnification, the other with step-magnification, the drum of which is machined in aluminium to 5 µm on the Haas VF-1s. Te Appasamy Keratometer, for measuring the curvature of the cornea, used to be made by a Japanese supplier and imported into India, but is now also made by Appasamy.


Inside the Factory With so many parts and products, it’s not surprising the


company spends a great deal of time and effort designing quick-change fixtures and fittings. Batches are oſten as small as two to five components, and some of the machines are set aside for development work, proving programs—generated by its EdgeCAM soſtware—and reducing cycle times. On the day of my visit, a long line of new Haas machines, still wrapped


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56  |  Page 57  |  Page 58  |  Page 59  |  Page 60  |  Page 61  |  Page 62  |  Page 63  |  Page 64  |  Page 65  |  Page 66  |  Page 67  |  Page 68  |  Page 69  |  Page 70  |  Page 71  |  Page 72  |  Page 73  |  Page 74  |  Page 75  |  Page 76  |  Page 77  |  Page 78  |  Page 79  |  Page 80  |  Page 81  |  Page 82  |  Page 83  |  Page 84  |  Page 85  |  Page 86  |  Page 87  |  Page 88  |  Page 89  |  Page 90  |  Page 91  |  Page 92  |  Page 93  |  Page 94  |  Page 95  |  Page 96  |  Page 97  |  Page 98  |  Page 99  |  Page 100  |  Page 101  |  Page 102  |  Page 103  |  Page 104  |  Page 105  |  Page 106  |  Page 107  |  Page 108  |  Page 109  |  Page 110  |  Page 111  |  Page 112  |  Page 113  |  Page 114  |  Page 115  |  Page 116  |  Page 117  |  Page 118  |  Page 119  |  Page 120  |  Page 121  |  Page 122  |  Page 123  |  Page 124  |  Page 125  |  Page 126  |  Page 127  |  Page 128  |  Page 129  |  Page 130  |  Page 131  |  Page 132  |  Page 133  |  Page 134  |  Page 135  |  Page 136  |  Page 137  |  Page 138  |  Page 139  |  Page 140  |  Page 141  |  Page 142  |  Page 143  |  Page 144  |  Page 145  |  Page 146  |  Page 147  |  Page 148  |  Page 149  |  Page 150  |  Page 151  |  Page 152  |  Page 153  |  Page 154  |  Page 155  |  Page 156  |  Page 157  |  Page 158  |  Page 159  |  Page 160  |  Page 161  |  Page 162  |  Page 163  |  Page 164  |  Page 165  |  Page 166  |  Page 167  |  Page 168  |  Page 169  |  Page 170  |  Page 171  |  Page 172  |  Page 173  |  Page 174  |  Page 175  |  Page 176  |  Page 177  |  Page 178  |  Page 179  |  Page 180  |  Page 181  |  Page 182  |  Page 183  |  Page 184  |  Page 185  |  Page 186  |  Page 187  |  Page 188  |  Page 189  |  Page 190  |  Page 191  |  Page 192  |  Page 193  |  Page 194  |  Page 195  |  Page 196  |  Page 197  |  Page 198  |  Page 199  |  Page 200  |  Page 201  |  Page 202  |  Page 203  |  Page 204  |  Page 205  |  Page 206  |  Page 207  |  Page 208  |  Page 209  |  Page 210  |  Page 211  |  Page 212  |  Page 213  |  Page 214  |  Page 215  |  Page 216  |  Page 217  |  Page 218  |  Page 219  |  Page 220  |  Page 221  |  Page 222  |  Page 223  |  Page 224  |  Page 225  |  Page 226  |  Page 227  |  Page 228  |  Page 229  |  Page 230  |  Page 231  |  Page 232  |  Page 233  |  Page 234  |  Page 235  |  Page 236  |  Page 237  |  Page 238  |  Page 239  |  Page 240