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This year’s American Academy of Ophthalmology meeting was one of the best ever with loads of new technologies entering eye care, including the first trifocal lens implant in the U.S., the Alcon PanOptix, the release of Cequa, an exciting new formulation of cyclosporine from Sun Pharma, and Beovu from Novartis, a novel anti-VEGF drug with a 12-week dosing schedule. But even more exciting than new FDA approvals are new ideas in the formative stages. No place has better showcases than the Ophthalmology Innovation Summit that takes place the Thursday before AAO Subspecialty Day. Here were some of my favorite presenting companies:
Allegro Ophthalmics. It’s hard for me as an anterior segment specialist to get excited about age-related macular degeneration treatments, unless they’re very different. And Allegro’s risuteganib, with an anti-integrin mechanism of action, reimagines treatment of dry AMD, diabetic macular edema and even retinitis pigmentosa. The company also has a molecule with promising early results for dry eye. Risuteganib has a combined mechanism of action that reduces mitochondrial dysfunction, mitigates inflammation and fights angiogenesis. Gains in visual acuity in these conditions appear to be significant and sustained.
The next three are novel ways of delivering medication to the eye.
TearClear uses a hydrogel mesh embedded in the tip of an eye drop bottle to remove benzalkonium chloride (BAK) from the eye drop solution as it exits the bottle. This allows storage of larger quantities of medication with this highly effective but somewhat toxic preservative, leaving the drops well preserved but preservative free when they touch the eye. It is a brilliant technology that can be applied to almost all of our current medications. Hydrogel is an inexpensive material, as is preserving drops with BAK, so I believe this has a promising future.
Eyenovia : This company was started by Sean Ianchulev, the Tony Stark of ophthalmology, who gave us the Transcend implant and the miLOOP. Eyenovia claims to have “shrunk the inkjet printer” to a small, hand-held device that allows almost any eye drop to be dispensed as an ultrafast micro-dosed mist when placed over the eye. From dilating drops in the clinic to latanoprost given at home, it is capable of maximizing local absorption but reducing systemic exposure.
Kedalion : This company has also reinvented the eye drop bottle with a device that directs a quick, comfortable stream of liquid about one-fifth the size of a traditional eye drop directly on the cornea. It eliminates waste and increases patient compliance, and it connects via Bluetooth to a phone app that allows compliance monitoring and delivery of reminders. While different, the concept is similar to that of Eyenovia and very promising.
There were many other promising technologies on display at OIS, and I encourage every physician and member of industry to attend this meeting if you want to learn what we will be using in future years. For me, it is always inspiring.
Disclosure: Hovanesian reports he has a financial interest in Alcon, Allegro, Eyenovia, Novartis, Sun Pharma and TearClear and no financial interest in Kedalion.