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In Glaucoma, Devices Go Eye-to-Eye with Drugs

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.

The treatment of glaucoma, the second leading cause of blindness in the world, has the hallmark of a clinical field that's somewhat early in its development. There is no clinical consensus regarding preferred therapies, and potential treatments are few and very different from one another. Current glaucoma therapies range from drugs offering maximum safety and minimal efficacy to surgical procedures offering great efficacy but also great risks.

Ten years or so ago, start-up device companies began to see if they might not be able to bring the paradigm of interventional cardiology to glaucoma by introducing less invasive...

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