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[ 1 ] CONFIDENTIAL Company Confidential Hypersonic Liquification & Auto Inserter Technologies Calvin Roberts, M.D. August 8, 2016 Presented products are in development and not currently for sale

RETINA COMPANY SHOWCASE - Bausch + Lomb

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Hypersonic Liquification &Auto Inserter TechnologiesCalvin Roberts, M.D.

August 8, 2016Presented products are in development and not currently for sale

[ # ]CONFIDENTIAL Company Confidential

[ # ] Company Confidential 1

Hypersonic LiquificationWhat is it?A new Stellaris PC accessory device for posterior vitrectomyUses a novel, closed, single-needle design with a small continuously-open port

23gHypersonicLiquification23gGuillotine

Stellaris PCHandpiece

[ # ]Presented products are in development and not currently for saleReview Slide2

Hypersonic Liquification

Stainless steel needle w/titanium nitride coating for lubricity, wearability & visibilityHandpiece TechnologyNeedle is mounted on a piezoelectric transducer element vibrating harmonically Yields virtual cut rate of approximately 1.7 million cuts per minute (cpm)Internal transducer elementNeedle tip w/laser-etchedport indicator

Handpiece

[ # ]Presented products are in development and not currently for saleReview slide

Inside the handpiece body is transducer element made up of a stack of 2 ceramic crystals sandwiched between machined metal parts that when energized with electricity, cause the attached needle to vibrate very rapidly in an up/down harmonic fashion. This translates to an effective cut rate of about 1.7 million cuts per minute.

You can also see the needle with exploded views of the port end and the thermoplastic insert-molded hub that I mentioned on the previous slide. The needle is designed with the hub molded around the needle for consistent performance.

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Hypersonic Liquification Technology5K Pneumatic Guillotine CutterHypersonic VitrectomyVitrectomy ApplicationGoal: Vitrectomy with less traction and turbulenceSource: Bausch + Lomb Surgical, St. Louis, MO

[ # ]Presented products are in development and not currently for saleReview Slide

They are shot at 5000 frames/second and looped until you clickPoint out the visible traction on the guillotine and the fact it sometimes does not cut but squeezes.Point out the smooth motion on the HyperV as well as the small amplitude of motion4

Hypersonic Liquification

Other possible applications FloaterectomyPosterior Vitreous Detachment (PVD) inducementSilicone oil removalLens removal

[ # ]Presented products are in development and not currently for saleReview Slide

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Hypersonic LiquificationElectron Microscopy (EM) Preliminary Findings (Cadaver Eye Vitreous)Comparison of the effects of pneumatic cutter and hypersonic liquification technology on collagen fibrils in vitreous:

Hypersonic LiquificationPneumatic Guillotine CutterSource: 2015 ARVO Poster - New Prototype of Ultrasonic Harmonics Vitrector (UHV) Histophatological Findings. Salvador Pastor, Richard Bonshek, Irion Luciane, Isaac Zambrano, Paul Carlin, Paulo E. Stanga

[ # ]Presented products are in development and not currently for saleReview Slide

Fibril fragmentation is significantly greater with hypersonic liquification

The mesh, which is formed by the collagen fibers of the vitreous gel, appears to be significantly more fragmented in the hypersonic liquification samples compared with the guillotine samples

Source: 2015 ARVO Poster - New Prototype of Ultrasonic Harmonics Vitrector (UHV) Histophatological Findings. Salvador Pastor, Richard Bonshek, Irion Luciane, Isaac Zambrano, Paul Carlin, Paulo E. Stanga

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Guillotine & Hypersonic Liquification ComparisonCharacteristicGuillotine*HypersonicLiquificationDuty cycle port openVariable, to 50%100%Port size.016 to 0.0220.007 to 0.010 Vitreous disruption regionInside PortOutside PortInner needlePresentAbsentFront port edge placementBehind inner needleNo limitDrive Pulsed PneumaticElectricCut rate< 5,000 CPM> 1.5 Million CPM

* Based on Bausch + Lomb guillotine vitrectomy cutter

[ # ]Presented products are in development and not currently for saleReview Slide

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Auto Inserter Entry Site Alignment (ESA) Cannula

[ # ]Presented products are in development and not currently for saleReview Slide

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Auto Inserter Entry Site Alignment (ESA) Cannula

Auto InserterManual InserterIOP(mmHg)Source: Dr. Brandon Busbee, Nashville, TN, January 29, 2016

[ # ]Presented products are in development and not currently for saleReview Slide

Reduced pressure spikes with auto inserter as compared to manual insertion

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Thank You

[ # ]Presented products are in development and not currently for sale

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VSS.0014.USA.16Stellaris is a trademark of Bausch & Lomb Incorporated or its affiliates.

Bausch & Lomb Incorporated.

[ # ]Presented products are in development and not currently for sale

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[ # ]Presented products are in development and not currently for sale