ASCRS News: 2021 ASCRS Annual Meeting 
September 2021

by Liz Hillman
Editorial Co-Director

Stephen Slade, MD, delivered the Charles D. Kelman, MD, Innovator’s Lecture at the Innovators General Session of the 2021 ASCRS Annual Meeting, focusing his talk on “Innovation for the Rest of Us,” the end producers of innovation. 

“Innovation is the creation of value. Innovation doesn’t happen unless we pick it up and actually use it. We take a product, process, or someone’s idea, innovate it, put it into a practical reality, and truly create more value,” Dr. Slade said.

A product, device, or technique needs to produce financially to succeed and often is an improvement of something not as good, or “reinvention.” “Where I think that I had, and all of us have, the opportunity to create value to innovate is in education,” he said, giving several examples from his experience. 

When Dr. Slade chooses to get involved with a particular technology, he asks the following questions: Is it unique, elegant? Does it meet an unmet need and/or have commercial potential? Do I have relevant experience and expertise? Will I enjoy this? 

Patients play a role in making innovation successful as well, Dr. Slade said, explaining that just because something gets FDA approval doesn’t mean it will get real-world approval. “If there is a choice, the patients will guide us,” he said.

Dr. Slade said being asked to give the Charles D. Kelman, MD, Innovator’s Lecture “couldn’t have made me happier.” 

“When I look at the people who have won this award, and we talk about standing on broad shoulders, this is like a freeway of shoulders for us to stand on,” Dr. Slade said. “I have so much gratitude and humility.”

The Innovators General Session also featured five other presentations on innovative advances and technologies. 

Jeffrey Goldberg, MD, presented on human corneal endothelial cell culture and magnetic cell delivery, currently being developed as a treatment for corneal edema. He described the technique being pioneered by Emmecell, in which human corneal endothelial cells are expanded in culture with the potential to benefit hundreds of patients. These donor cells are then combined with magnetic nanoparticles, which coat the cells. The cells are injected into the anterior chamber, and a magnetic patch is worn up to overnight to facilitate localization and integration into the endothelial layer. 

The first in-human trials outside the U.S. have taken place with two different doses and two different formulations studied. Patients in the research, according to Dr. Goldberg, had end-stage severe corneal edema and after 12 months of follow-up, nine of the 21 patients had a 3 or more line gain in visual acuity. No serious safety issues were reported. The FDA accepted an IND for a Phase 1b clinical trial for up to 18 patients, which has begun in the U.S. Once best dose is identified in this study, Dr. Goldberg said the technology will move to Phase 2.

Sharon Bakalash, MD, PhD, described the augmented reality headset being developed by Beyeonics. These systems are based on technology originally designed as head-mounted displays for aviators. She described the current concept of the “surgeon cockpit” designed to comply with both anterior and posterior segment surgery.

The headset technology allows the surgeon to bring up pre- and intraoperative information via side screens on demand, thus enabling more informed decision making in real time. It provides a natural, 3D, immersive display that is equivalent to a 4K monitor at 1.5 meters, she said. She also explained that the user is able to control all functions, including focus, zoom, X-Y axis, intensity, and data menus with head gestures and voice controls. 

Advantages of such technology include unique attributes like panning, which enables working under high magnification while maintaining spatial orientation, enhanced ergonomics, teaching and remote training capability, and a small footprint in the OR.

Ayman Naseri, MD, presented on ForSight VISION6’s Opira accommodating IOL, still in development. He gave an overview of why an accommodating IOL is needed and how Opira takes a different approach. He described Opira as a ciliary muscle-driven, capsule-fixated, dynamic, shape-changing IOL. He also showed research that found Opira was able to deliver high-quality monofocal-like distance vision across the range of vision.

Yoram Solberg, MD, PhD, described the Eagle device (Belkin Vision) for direct SLT. Despite the LiGHT trial supporting the benefits of first-line SLT therapy for open-angle glaucoma, Dr. Solberg said its adoption has been slow. Reasons could be the current technology’s gonio lens-contact procedure, the time it takes, its side effects (though transient and mild), and the fact that it’s not widely provided. 

The tabletop Eagle system, Dr. Solberg explained, uses advanced imaging to locate the exact treatment area and within 2 seconds, 120 laser applications are applied, delivering the SLT treatment. The first in-human trial of 15 patients showed the technology to be safe and effective. It reduced IOP, on average, by 22%, and of the 14 patients in the study who were on medications, 11 were medication-free 6 months post-treatment. 

Dr. Solberg said the technology is in a pivotal trial outside the U.S. comparing direct SLT to traditional SLT with primary results expected by early next year. 

Gilad Litvin, MD, discussed the CorNeat KPro, a completely synthetic artificial cornea. The device features a nanofabric skirt, manufactured through electrospinning technology, that facilitates integration with resident ocular tissue. Dr. Litvin detailed the histological findings accumulated from in vitro and animal research, showing collagen deposition, cellular invasion and proliferation, and capillary formation within the skirt. This mechanism anchors the device to the subconjunctival space, which heals vigorously, according to Dr. Litvin. The device has undergone animal studies and the first in-human implantation occurred earlier this year.

Overall, Dr. Litvin said the technology highlights the ability to integrate artificial, mechanical, and other synthetic components into the human body seamlessly. 

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Relevant disclosures

Bakalash: Beyeonics Surgical
Goldberg: Emmecell/Emmetrope Ophthalmics
Litvin: CorNeat Vision
Naseri: ForSight VISION6
Slade: None
Solberg: Belkin Vision