Did you miss last month’s Ophthalmology Technology Forum (OTF)? No need to worry, we’ve got you covered.
Our latest recap includes a panel discussion involving industry and key opinion leaders (KOLs) from across the ophthalmic field making strides in anterior segment surgery.
First things first: Who were these leaders?
The panel featured the following:
- Ehsan Sadri, MD, FACS, FAAO (moderator)
- CEO and Founder: Visionary Eye Institute
- Leo Edward Otero
- Senior Director, Market Development & Global Advisory Boards, U.S. Surgical Marketing: Alcon, Inc.
- Marjan Farid, MD
- Professor of Ophthalmology, Director of Cornea, Cataract, and Refractive Surgery: Gavin Herbert Eye Institute, University of California, Irvine
- Alex Lopez
- Chief Commercial Officer: Ace Vision Group
- Lisa Nijm, MD, JD
- Founder and Medical Director: Warrenville Eyecare and LASIK
- Assistant Clinical Professor of Ophthalmology: University of Illinois Eye and Ear Infirmary
- CEO: Women in Ophthalmology
- Founder: Real World Ophthalmology
- Chief Medical Advisor for Ophthalmology: Trukera Medical
- Adam Szaronos
- President & CEO: Trukera Medical
Alrighty, now let’s dive in.
To kick things off, the panelists discussed market opportunities.
Zeroing in on Alcon, Otero noted Alcon’s anterior segment industry.
Fact: Since 2018, the company has invested $4.3 billion in core R&D activities across vision care and surgery—with 28 surgical product launches, he noted.
- Included in those: The Clareon Collection of next-gen intraocular lenses (IOLs) such as PanOptix (launched in 2019) and Vivity (launched in 2020).
“We’re constantly bringing new things to market,” Otero said to Glance. “With our ultimate goal of helping people see brilliantly, we have to produce new technology that meets unmet needs and improve the platforms we have—with meaningful improvement and efficiency.”
- For example: The 2003 launch of the Infiniti Vision System (a phacoemulsification platform) replaced the Legacy Series of phaco systems.
- More recently: The Infiniti has phased out in favor of Alcon’s CENTURION Vision System with ACTIVE SENTRY.
“As we head into the future, we have to come up with something to replace CENTURION,” Otero said. “Not because it’s broken, but because, with our capabilities, we can come up with ways to make improvements to these technologies. And if there’s ways to make cataract removal better, why wouldn’t we pursue those avenues?”
- Speaking of improvements: In June 2024, Alcon was granted FDA clearance for the UNITY Vitreoretinal Cataract and Cataract stand-alone systems (VCS/CS), designed to provide "significant workflow efficiencies" that surpass even the CENTURION system.
While Alcon expects cataract surgery volume to reach an estimated $4.9 million in 2024—headed to 5 million by 2025—he noted a simultaneous decline in the number of surgeons capable of performing these surgeries.
“The access to surgeons will be trying, and I don’t know that everyone will be used to that,” Otero said during the discussion. “That’s one of the issues that’s going to be exciting to figure out.”
What’s Alcon’s other focus?
Its second innovation in the works: a premium pay channel.
Most recently, Market Scope’s ranking of advanced technology intraocular lenses (IOL) hovered around 19% penetration, according to Otero.
“Over the last three quarters we’ve seen an uptick,” he said. “We’re hoping by the end of this year that we could see that trend continue.”
- Industry note: Earlier this year, Alcon’s Vivity extended-depth-of-focus (EDOF) lens surpassed over 1 million implants globally—a major win for the IOL that uses the company’s patented non-diffractive Wavefront-Shaping X-WAVE technology.
And from an academic standpoint?
Bridging the gap between academics, new residents, and fellows graduating into ophthalmology as well as having them realize the potential of industry collaborations is key, according to Dr. Farid. “This is where all the exciting technology happens, and it’s one area that can be expanded on,” she said.
Similar to Otero, Dr. Farid noted the increased volume of cataract patients. However, she added that the current innovations in IOL technology in practice today—such as a full range of vision lenses and customized lenses postoperatively—are designed to address the needs of patients, particularly for presbyopes.
Also on her radar: corneal surgery and endothelial cell technology.
“I want to bring that same innovation from cataract into cornea, and see that innovation bridging cornea and refractive,” she said.
Let’s hear from Trukera Medical.
Szaronos stated that the company is zeroing in on premium outcomes—not just the refractive target for patients, but also the quality of vision.
“For us, the right definition for premium outcome is not just landing the refractive target, but really owning and controlling the factors that might be impacting the quality of vision,” he stated.
What this means for Trukera Medical: Honing in on osmolarity for its ScoutPro Osmolarity System, a portable device intended to measure the osmolarity of human tears to help diagnose dry eye disease (DED).
- Note: The system launched in the U.S. in September 2022 as the company’s first product since rebranding from TearLab.
Why osmolarity: “This can cause as much scatter in vision as a Grade 2 or 3 cataract,” Szaronos said, “which explains a lot about not achieving that ‘20/20 happy’.”
He added that the company is pushing to redefine and support physicians in not just delivering a good refractive result, but also the “20/20 happy” outcome.
How about from the private practice perspective?
Dr. Njim stated that ophthalmic private practice is in a unique position—particularly from a post-pandemic standpoint—with more patients to treat.
“More patients are coming in organically, and the volumes have gone up across the board post-COVID,” she said. “People are more in tune with wanting these high-quality premium outcomes.”
Other factors Dr. Njim noted as playing key roles include:
- Overall evolution of ophthalmic technology
- Greater understanding of the ocular surface
- IOL advancements
- Incorporation of patient-reported outcomes into evaluations
- Artificial intelligence utilization for customized/personalized patient offerings
“We’re going to need these new technologies within cataract surgery, digitalization, and efficiencies between the operating room and clinic to move forward and take care of this rising number of patients,” Dr. Nijm said.
This volume may be difficult to treat… let’s zero in on the presbyopia market.
Amid the country’s rising inflation, Lopez noted that Ace Vision is working to bring its products—such as the Laser Scleral Microporation, a microporation therapeutic technology—into the broader economy of patient demographics by focusing on funding.
“The fuel of our innovation is funding, and that sentiment trickles down into our industry,” he said. “So we have to think creatively about how we break through that to make sure we continue to fund innovation and bring it into our space.”
Ace Vision’s focus: the unmet need within the presbyopia market (totaling 128 to 139 million presbyopes in the U.S.—nearly 90% of adults over the age of 45).
“This expectation on happiness and outcomes grows each year thanks to the innovations and technologies that we have,” Lopez said.
Down the road, he said, presbyopia patients will ideally have multiple options for patients to choose from, beyond drops to get rid of their glasses.
Ace Vision’s role, however, will be to provide patients the “next tier solution,” according to Lopez.
“We’re planning to integrate the optometrist into the presbyopia management system, as they play a critical role in the management and care of these patients,” he told Glance.
“An important part of our strategy is to have an integrated care model involving both optometrists and ophthalmologists,” he added, “And it starts with the optometrist in providing the proper information and education for a patient on their presbyopia options: a minimally-invasive, in-office treatment in addition to glasses and contact lenses; a toolbox.”
As a result: The company is “hyper-focused on the surgeon and patient to make sure we deliver those outcomes as we get closer to the regulatory and commercialization path.”
Circle back to the academic side: What industry challenges exist?
Dr. Farid called out the “elephant in the room”: cost and access to technologies
She noted that academic institutions across the country don’t necessarily have as much access to technology as they should due to the funds required.
In addition to this drawback is the onus put on both ophthalmic surgeons and their institutions to educate themselves on which technology platforms and advancements will benefit them and their patients the most.
Speaking of education, has AI changed ophthalmic training?
Not quite, but the potential for its impact in the operating room (OR) among residents and fellows is certainly in the near future, Dr. Farid said.
“The more we can get AI and other technologies to help with training residents and fellows—that takes a lot of the pressure off of the attendings,” she said.
Such tasks like baseline training methods and patient-reported outcomes would enable ophthalmologists to review their surgical techniques, skills, and outcomes, Dr. Farid added.