An Early Peek at Glaucoma Devices
This article was originally published in Start Up
The clinical community has long been searching for a safe and effective surgical alternative to drugs for glaucoma, but the field has moved slowly. A decade ago, non-invasive laser procedures began earning a place as a second-line therapy with limited durability. Invasive surgeries are reserved for end-stage glaucoma because of their complexity, their serious complications, and their high failure rates. Venture firms believe a large, unmet clinical need represents a new $1 billion device market, and the pace of glaucoma device company creation is picking up.
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Glaucoma is of serious interest to VCs and strategic investors because of its sheer size; the disease affects 3 million people, most of them managed by drugs. Glaucoma drugs have created a $4 billion market, but have several problems, the greatest of which is non-compliance. Glaukos and other device companies aim to introduce devices that are safe and efficacious enough to compete directly with drugs, rather than standing in as an alternative to today's glaucoma surgeries reserved for end-stage patients. Glaukos recently marked a first of its kind victory; with a tiny implantable ophthalmic stent, Glaukos emerged from a PMA clinical trial that convinced an FDA panel of the benefit-to-risk ratio of its approach when used as a first-line therapy in a select group.
In the field of glaucoma, there are a lot of unknowns because it hasn't previously been feasible to continuously monitor intraocular pressure. Sensimed was formed to do just that. The young company is developing a sensor that would provide 24-hours worth of intraocular pressure data as an alternative to the point-by-point measurement systems available today. The company likens its device to the Holter monitor in cardiovascular disease-a device that can yield a comprehensive set of diagnostic data as a patient goes about his or her daily life.
Having validated high intraocular pressure as a certain target for intervention, the Ocular Hypertension Treatment Study spurred on a new wave of innovation in medical devices for glaucoma. Numerous start-ups formed five or six years ago are now beginning to run their devices through clinical trials. Indeed, the field seems to have gained a critical mass of attention. Start-Up has identified more than a dozen emerging device companies treating glaucoma, and the disease remains a target for development programs and acquisitions on the pharmaceutical side as well.