The ophthalmic market
The first session of Eyecelerator, “Do the Eyes Have It? Ophthalmic Commercial Dynamics and Investment Opportunities,” was moderated by Gil Kliman, MD, MBA, and Ramin Valian, of AbbVie, and featured a panel discussion, which highlighted financial topics.
Kristen Harmon Ingenito, MBA, of Market Scope, noted that the ophthalmic market was valued at $48.7 billion in 2024. The fastest growing space is glaucoma surgical device, as well as IOLs, she said.
Neha Begwani, MBA, of Morgan Stanley, said it’s about where the technology plays in the existing space. There are a lot of pools of capital out there, she said, adding that there are many in adjacent areas of ophthalmology wanting to broaden their reach. Looking at the market 3–5 years ago, it was different, but now there are more pools of people wanting to build their own ophthalmology ecosystem.
Those on the investment side of the panel commented on key attributes that make them want to invest in an early-stage eyecare venture. James Murray, JD, of ExSight Ventures, said it’s the people who drive the product forward. Meanwhile, Roger Zhang, PhD, of Samsara BioCapital, said he likes to start from the end and know what’s going to be a big deal for patients and providers, then work backward to increase the probability of success.
Discussing the importance of big pharma collaboration with start-ups in ophthalmology, Dr. Zhang said that one thing he particularly likes about ophthalmology is that smaller companies have been able to bring things to market and capture that for themselves. Capturing value credibility with amounts of capital that you can raise is one of the most attractive things about ophthalmology, he said.
Closing out the discussion, audience members voted on the technology that they’re most excited about, with just over 50% indicating retina therapeutics, close to a quarter answering oculomics/AI/robotics, around 20% indicating glaucoma drug delivery, and a low percent noting novel IOLs.
Panelists also indicated which technologies they’re most excited about in ophthalmology. Mr. Murray said retina is the “monster in the room” but added that he’s also excited about oculomics/AI/robotics.
Garrett Hamontree, MBA, of Visionary Ventures, discussed some of the white space areas and mentioned corneal cell therapy, particularly with the recent acquisition of Aurion Biotech by Alcon. He also noted developments for neurotrophic keratitis and limbal stem cell deficiency. In glaucoma, there are a lot of treatments for IOP, but no one has “cracked the nut” on nerve protection, he said.
Robotics
The discussion at Eyecelerator shifted to robotics and applications in ophthalmology. Frederic Moll, MD, kicked off the panel discussion, speaking about his 30 years of history with robotic surgery. He said the big question in ophthalmology is: Why robotics? This means figuring out the need, where the development is going, and how it’s driven by that need. Dr. Moll said he was trained in surgery at a time when a minimally invasive technique was more of an idea than a practice, but he got very involved in laparoscopic innovation. Early on, he said laparoscopic surgery looked great from the outside, but if you looked at the surgical technique going on inside, there were good general surgeons who couldn’t tie a knot. He described the stages of acceptance of these minimally invasive procedures, then turned the discussion back to ophthalmology, saying that it comes back to the clinical need of why you need a robot. You need to know what you are adding and if you’re doing a good thing for the patient, he said.
Physicians on the panel commented on some of the problems that robotics can help solve in ophthalmology.
David F. Chang, MD, said, from a big picture standpoint, it’s about scale. He added that there is going to be an issue with manpower in ophthalmology in the next several decades. It’s difficult to train someone, and a lot of effort goes into training in residencies. If you could get a fully autonomous system, and once you do, train it with AI software, you can multiply that, he said, and this helps solve the manpower problem going forward.
Allen Ho, MD, noted that cataract surgery has different challenges than retina. Cataract has more predictable maneuvers. Democratizing the level of care is another potential benefit of robotic surgery. Gifted surgeons are rare, Dr. Ho said. The elements of being a gifted surgeons are knowing what to do and doing the maneuvers. We could train better if we could democratize the execution of what they want to do, he said.
Dr. Ho thinks visualization is a key part of retina robotics surgery moving forward, and robotics could help better handle the complexities of retina surgeries. When visualization brings in 3D control and visualization with the robotics, this could generate a lot of data.
Dr. Moll said the challenge of entering robotics is the need for a lot of money, the time to get it right, and a talented engineering team. It’s a higher bar and enormous commitment, he said.
The Winning Pitch Challenge
The Winning Pitch Challenge, a Shark Tank-style competition, featured pitches from several early-stage ophthalmology innovators, with judges and the audience voting to award cash prizes at the end of the session. Moderators of this session were Vance Thompson, MD, and Julie Schallhorn, MD, with judges Erin Powers, MBA, Namrata Saroj, OD, and Firas Rahhal, MD.
First place: Leanne Labriola, DO, MBA, InnSight Technology
This technology involves tear fluid testing for personalized medicine. Dr. Labriola noted that her company has been studying tear fluid for 10 years and has created a first-in-class device for direct tear fluid measurement of proteins that can tackle some of the greatest healthcare challenges.
She gave the example of diabetes and noted that 25% of healthcare dollars are spent on diabetes. There are 34 million Americans with diabetes, and 98 million Americans are pre-diabetic. A solution to this would be engaging eye professionals in glycemic screening.
Enter the OcuCheck device, which Dr. Labriola said can do tear fluid testing of protein biomarkers. It’s the first electrochemical device for direct tear fluid testing of protein biomarkers and provides more accurate and rapid results, validated with patented science, she said. The OcuCheck includes biomarkers for dry eye, diabetes, and neurodegenerative disease. Particularly focusing on dry eye and diabetes will target a large market, she said.
OcuCheck compliments the dilated exam by adding objective results, Dr. Labriola said, adding that it’s tech interpreted, has a numeric benchmark, and is non-invasive.
Second place: Joaquin Sosa-Lockward, MD, Neobuckle
This technology presents a new way to perform scleral buckle. Dr. Sosa-Lockward began by describing some of the issues with scleral buckle, including a steep learning curve, preference for vitrectomy, bleeding, patient discomfort, and complications. You also have to determine how tight or loose a buckle should be.
The Neobuckle transforms buckle surgery using the same material and technique but improving efficiency, he said. It includes an integrated sleeve, three tension markers, and a triangular band tip.
Dr. Sosa-Lockward noted that this is a product that hasn’t been updated since the 1960s, so there is a need, and it’s a market that can expect growth in the coming years.
Third place: Nikolas Pontikos, PhD, Eye2Gene
This presentation focused on an AI-powered precision ophthalmology platform. Dr. Pontikos said he and his colleagues wanted to unlock the therapeutic potential of precision ophthalmology, noting that there are 6 million patients with genetic eye diseases, which are the leading cause of blindness in people under 40 years of age.
Eye2Gene’s solution is the first AI-powered platform trained on retinal scans and genetics for precision ophthalmology. The AI algorithm leverages retinal scans to give immediate, actionable insights for genetic eye diseases. Dr. Pontikos said it involves a simple drag and drop interface at the point of care and adds value to the patient journey by improving diagnostic yield and matching to treatments/trials. You can match patients to trials in its database, he said, noting that this technology can outperform human experts.
Editors’ note: The speakers at Eyecelerator have financial interests with the companies they represent.
ASCRS Live!
On Thursday evening, ASCRS hosted a dinner as part of its ASCRS Live! series. This program is targeted to a smaller audience to foster meaningful discussion and connections. Open to both members and nonmembers, these events are an opportunity to bring a colleague to engage on current topics and learn about ASCRS.
Faculty at Thursday’s event included ASCRS Live! Program Co-Chair Kendall Donaldson, MD, ASCRS President Francis Mah, MD, and ASCRS Treasurer Cathleen McCabe, MD.
The faculty kicked off the event by highlighting the value of ASCRS, sharing personal stories of how and why they got involved with the Society.
Dr. Mah noted that he first joined when he was a resident because it was the best opportunity in education. “I was able to reach out to people on the podiums and ask questions,” he said. Dr. Mah added that being able to experience the newest technologies in the Exhibit Hall at the Annual Meeting was an added benefit.
Dr. McCabe stressed the surgical focus of ASCRS, noting that everything is discussed, from complications to new techniques to best approaches. It’s an interactive industry, she said. Being part of the cutting edge is part of the environment ASCRS has created, but they also discuss complications and don’t just show the best cases.
Dr. Donaldson noted that she first went to an ASCRS Annual Meeting as a second-year resident and later joined a committee. This was around the time the femtosecond laser was approved, she said, adding that it gave her the opportunity to meet and interact with many of her heroes in the field.
There is still one final ASCRS Live! event in 2025 on November 13 in Dallas, Texas. Learn more about ASCRS Live!
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