At the 3rd edition of iNovation® Day, held during the 42nd Congress of the European Society of Cataract and Refractive Surgery (ESCRS 2024), the stakes were high, and the innovations even higher. In the spotlight was the Innovators Den, a Dragons’ Den-style showdown where three daring EyeCare Pioneers faced off, vying not just for bragging rights but for the opportunity to shape the future of ophthalmology.
The Innovators Den is a competition that brings together some of the brightest minds in the field, all vying to fast-track their groundbreaking innovations in eye care. Designed to accelerate the development of innovative technologies that address unmet needs in ophthalmology, the Innovators Den offers a unique platform for inventors to showcase their ideas, gain crucial feedback and move closer to making their dreams a reality.
The journey for these innovators is no easy feat. As Session Chair Dr. Vance Thompson (USA) explained during the session, applicants begin in Round 1, where they are connected with financial resources and paired with seasoned mentors who guide them through refining their business models and pitch decks. But the ultimate prize lies in reaching the final round—Innovation Day—where they get the chance to present their concepts to a panel of esteemed judges.
Three industry heavyweights presided over today’s event: ESCRS President Filomena Ribeiro (Portugal), Panakes Partners Founder Diana Saraceni (Italy) and Advent Life Sciences General Partner Shahzad Malik (United Kingdom). Each brought their wealth of experience and razor-sharp insights to the table, grilling the three EyeCare Pioneers who had made it this far. Their questions were pointed, their feedback invaluable, and their scorecards would ultimately determine which innovations had the greatest potential to reshape the future of ophthalmology.
A novel tonometer
Dr. Maria Iglesias from Barraquer Ophthalmology Center (Barcelona, Spain) was the first EyeCare Pioneer to pitch. Her innovation offers a solution to a long-standing problem that has challenged ophthalmologists for years. “It is a well-recognized unmet need for ophthalmologists that the most popular tonometer in the market, the Goldmann applanation tonometer, registers lower myopic IOP values after laser refractive surgery,” she began.
This issue, Dr. Iglesias explained, can lead to delayed diagnosis of glaucoma in patients who have undergone LASIK, a concern that deeply troubles the ophthalmology community. With millions of myopic patients having undergone this surgery, the risk of misdiagnosing ocular hypertension looms large.
But Dr. Iglesias was not there to dwell on the problem; she had a solution—her newly developed LASIK tonometer, designed to solve the discrepancies in IOP readings after laser refractive surgery.
What makes the LASIK tonometer revolutionary is its ability to measure IOP accurately, without the complications introduced by LASIK surgery. The device functions similarly to the well-known Goldmann tonometer, with one key difference: it compensates for the changes in corneal biomechanics that occur after laser surgery. “We’ve discovered that the center of the cornea has minimum central resistance when touched by Goldmann after laser surgery,” Dr. Iglesias said. “However, if an external converse force is applied, corneal biomechanical recovery is observed, producing a contact pressure profile similar to what existed before surgery.”
The LASIK tonometer has proven to be highly effective, as evidenced by its clinical trials. “Three months after the surgery, the LASIK tonometer registered the same pressure as Goldmann did before the surgery, and even after one year, it was the only device that consistently correlated with the pre-surgery pressure,” reported Dr. Iglesias.1
An innovative diagnostic platform
Harilaos Ginis, PhD, from Diestia Systems (Athens, Greece) pitched next, unveiling a diagnostic platform designed to tackle a long-standing issue in ophthalmology: the gap between optical measurements and actual visual performance in cataract patients.
“We can measure the optics,” Dr. Ginis explained, “but we don’t know very well what is going on in terms of visual performance.” This disconnect often leaves doctors perplexed—how can a patient have good acuity, yet still report dissatisfaction with their vision? “We are here to bridge this gap,” he said, setting the tone for the revolutionary technology he was about to introduce.
The heart of the problem, Dr. Ginis explained, lies in the complexities of multifocal and diffractive IOLs. Patients who receive these lenses often experience a range of issues, including loss of contrast and stray light, leading to halos and other unwanted visual phenomena. “As you go through focus,” he said, referring to trifocal IOLs, “half of the light is focused vertically, and half is horizontal.” This split in focus can distort vision, making it difficult for patients to enjoy crisp, clear sight.
Enter Diestia Systems’ novel solution—a diagnostic platform capable of quantifying vision in real-time and giving ophthalmologists an unprecedented understanding of how these premium lenses perform in patients. “What if we could extract the focus curves in vivo,” Dr. Ginis proposed, “and differentiate between the acuity and quality of vision that we see in some multifocal lenses?”
The technology behind the platform is as cutting-edge as it sounds. Using structured light projected onto the retina, combined with machine learning algorithms, the system captures detailed images of the eye’s performance. In less than 258 milliseconds—before the pupil can even react—it collects data, allowing for an intricate analysis of optical quality.
This platform promises a comprehensive optical assessment, offering insights into far, intermediate and near refraction, as well as astigmatism analysis, stray light and image quality metrics. It’s more than just a tool for measuring acuity; it dives deep into the root causes of patients’ visual complaints, addressing phenomena like halos, stray light and even the dynamics of the tear film.
A new way to deliver drugs
Last to pitch was Jean Garrec, co-founder and CEO of Biophta (Paris, France). His company offered an innovative solution for drug delivery—a mini-tablet that dissolves directly on the eye like a contact lens. Mr. Garrec began by addressing the most persistent issues in ophthalmic care: poor patient adherence to eye drop regimens and the high-cost and invasiveness of intravitreal injections. Biophta’s mini-tablet is designed to change all that.
Once applied to the eye, it instantly transforms into a hydrogel pellet that stays in place, delivering a continuous and controlled low dose of medication for seven days. This eliminates the need for patients to remember multiple daily doses or endure frequent and painful injections. “We are able to show that we have a sustained release in the retina with a topical treatment, as opposed to an implant,” Mr. Garrec said, highlighting the breakthrough nature of their product.
Additionally, the mini-tablet is more effective at administering medication. “Ninety-five percent (95%) of the drug content in an eye drop is wasted,” Mr. Garrec explained, as traditional drops stay on the eye for only a brief moment, leading to insufficient absorption. The problem, he noted, is not just inconvenience but the necessity of frequent, high-dose applications to achieve therapeutic results.
The potential applications for this mini-tablet are vast. Already showing efficacy in phase 1 trials, where it was compared to standard eye drops for lowering intraocular pressure (IOP), the technology has implications beyond glaucoma treatment, including dry eye disease, macular edema and diabetic retinopathy. Mr. Garrec even hinted at its future use in topical gene therapy.
After a brief pause to tally the judges’ scorecards, the winner of this year’s Innovators Den was revealed: Dr. Iglesias and her LASIK tonometer. While Dr. Iglesias took home the top prize, all three finalists left with valuable insights and guidance, knowing their innovations have the potential to be transformative, no matter today’s result.
Editor’s Note: Reporting for this story took place at the 42nd Congress of the European Society of Cataract and Refractive Surgery (ESCRS 2024), held from 6-10 September in Barcelona, Spain.
Reference
- Iglesias M, Kudsieh B, Laiseca A, et al. Intraocular pressure after myopic laser refractive surgery measured with a new Goldmann convex prism: correlations with GAT and ORA. BMC Ophthalmol. 2022;22(1):79.
