ONLINE EXCLUSIVE
Cornea
February 2023
by Ellen Stodola
Editorial Co-Director
I had the honor of co-founding The Winning Pitch Challenge with retina specialists John Pollack, MD, and David Williams, MD, in 2017. Our dream was to spur innovation by assisting ophthalmologists with great ideas looking for advice on whether their concept was commercially viable and, if so, help them with the necessary steps to maximize their chance for success. We thought that if we could improve and facilitate the pace of innovation, we would ultimately improve patient care in our world at a faster rate. The Winning Pitch Challenge website was designed to achieve this goal by providing ophthalmologists with free access to key educational resources, highly experienced mentors with relevant business and innovation cycle knowledge, networking opportunities, and exposure to potential financial resources and guidance that could help them overcome critical early-stage obstacles, such as securing intellectual property, developing a working version of the product, identifying a team, and designing early-stage studies. Our hope is that ophthalmologists with great ideas will engage and submit their ideas and ultimately, if chosen, present their idea in a Shark Tank-type setting at the Eyecelerator@ASCRS and Eyecelerator@AAO meetings.
The next Winning Pitch Challenge will take place Thursday, May 4 in San Diego, California, at Eyecelerator@ASCRS 2023. This will be a great session to attend for those interested in the innovation process to either submit their idea and potentially present or just come learn about the process and hear the three finalists’ innovation journeys as they pitch to four judges in an energy-filled session co-moderated by my partner John Berdahl, MD. This year, for the first time, we have a fifth judge—the audience! It is an exciting program, and the past winners have felt it helped them to either found their company or take their small company to another level on the world innovation stage.
—Vance Thompson, MD, Director of The Winning Pitch Challenge
At The Winning Pitch Challenge in 2020, the top prize went to Sunil Shah, MD, presenting on Photon Therapeutics and its device for ultraviolet light treatment for corneal infections. Simon Dean, MBChB, MSc, spoke with EyeWorld about the company’s technology and updates since winning the competition.
The concept for the ultraviolet light treatment, Dr. Dean said, came when experimenting with UVC while designing and building a crosslinking device. He found that UVC was safer than expected, more like UVA, with UVB being the one causing skin cancers. He experimented and found only a few seconds of gentle UVC light was not only safe but effective for killing all microbes.
Dr. Dean and Professor Shah co-founded Photon Therapeutics, and after successfully gaining a patent for the technology, further research was done with Jennifer Craig, PhD, in New Zealand. “This robust preclinical data formed the basis of The Winning Pitch Challenge presentation, for which Professor Shah presented on behalf of Photon Therapeutics, and the whole team was incredibly proud of the success,” Dr. Dean said. “Since then, Photon Therapeutics has made significant progress with a device now ready for clinical studies and sales forecast within a year. So far, we have tested it on various pathogenic bacteria, fungi, mixed infections, and antibiotic resistant bacteria, with the same low dose of only a few seconds killing all of these equally well. This makes it a promising technology for empiric and safe initial management of any corneal infection or presumed infection.” Dr. Dean added that it will likely have the best effect if applied early, but it can help reduce microbial load for any infection regardless of severity or causative organism. “For reduction of scarring and vision loss from infection, it will be best if used as early as possible. Our goal at Photon Therapeutics is to have it widely accessible and especially in locations where antibiotics may not be so readily available,” he said.
Source: Photon Therapeutics
This technology, Dr. Dean continued, is very simple. “We have known that UVC light can be used for sterilizing, but the fact it was safe at low doses on living tissue made it possible to use to treat infections of the eye,” he said.
The LED uses a patented wavelength that is more targeted at microbes than host cells. These LEDs replace traditional UVC discharge tubes that emit wavelengths that are effective only in large doses. It is designed to be used in the office to visualize any infection or abrasion and treat on the spot. It’s a small handheld device that has a camera and a screen with white and blue illumination similar to a portable slit lamp. It is designed to fit on the office slit lamp as well for ease of use. “Initially it will most likely be used alongside antibiotic drops, as we have done the studies to show that doesn’t reduce its effectiveness, and most clinicians will still want to use drops,” Dr. Dean said. “Eventually, as we gather more efficacy evidence, it is possible it will replace drops for small infections or in remote areas where drops aren’t available.”
Research on this technology has been conducted in Auckland, New Zealand. It included collaboration with Dr. Dean as inventor and manufacturer of the prototypes, and Professor Craig and her team, including Sanjay Marasini, PhD, with papers published in The Ocular Surface.1,2 These publications include safety and efficacy results, Dr. Dean said. Endpoints for efficacy have been wound healing monitoring epithelial closure, post-treatment culture, and reduction of bioluminescence of the bacteria. “Using bioluminescent bacteria has allowed an elegant way to monitor corneal infections in real time for preclinical work (the bacteria stop glowing when they die),” he said. “Interestingly, all untreated eyes got worse, and in the treated eyes, most had complete wound healing in 24 hours, reduction of bioluminescence to below measurable limits, and all had a negative culture. For clinical studies, we will be looking primarily at wound healing as a surrogate for treatment success, with culture as a secondary endpoint (acknowledging cultures are frequently unrewarding).”
In terms of availability of the device, Dr. Dean said that Photon Therapeutics is releasing it to the veterinary market initially, as the regulatory pathways are shorter. “For human use, the predicted time for release will be 3–4 years.” He added that both he and Professor Shah, being corneal surgeons, are very keen to be able to use the device and see the benefit in optometry and ophthalmology clinics to reduce the severity of infections on presentation, without having to wait for culture or rely on antibiotics, especially with increasing antibiotic resistance being a significant issue these days.
In addition to the preclinical research that has been conducted in New Zealand, Dr. Dean said that they plan to have collaborative clinical studies set up initially in the U.K., but the company is also speaking to other international sites as well. “The device has been designed to meet all the regulatory standards for human use, and while we plan to release it to the veterinary market first, in parallel, we have a team working on the regulatory work to get to the human market,” Dr. Dean said.
“We are excited to see it being used soon for corneal infections, but as we are finding out with more research, it is safer than even we thought, so it could be used for prophylactic treatment of abrasions, for preop sterilization for intravitreal injections, cataract surgery, etc.,” Dr. Dean said. “The scope of its use will be limited only by the imagination of the expert clinicians using it; there may be things we haven’t thought of yet.”
About the doctor
Simon Dean, MBChB, MSc
Chief Scientific Officer
Photon Therapeutics
London, U.K.
References
- Marasini S, et al. Effect of therapeutic UVC on corneal DNA: Safety assessment for potential keratitis treatment. Ocul Surf. 2021;20:130–138.
- Marasini S, et al. Preclinical confirmation of UVC efficacy in treating infectious keratitis. Ocul Surf. 2022;25:76–86.
Relevant disclosures
Dean: Photon Therapeutics
Contact
Berrow: paul.berrow@photon-therapeutics.com
Dean: simon.dean@photon-therapeutics.com
Shah: sunil.shah@photon-therapeutics.com
