Misight vs Naturalvue

Misight is clearly the industry leader in myopia control using soft multifocal lenses with sales last quarter of US$15.4M, and with likely 2023 sales somewhere north of US$70M.

I sometimes wonder if it is really understood how much more effective Naturalvue looks to be in controlling the progression of myopia.

The best way to visualise the difference between the two lenses, based on current data, is to look a frequency histogram of children treated with both.

The below graph is take from Chamberlain et al 2019 which reported the 3-year data for the Misight RCT. The grey bars are control children (eyes) and the green are those given Misight. I've drawn a red line at -0.25D which is usually considered the cut-off for a clinically meaningful increase in myopia (i.e. a more negative D value).

In Cooper et al 2022, they matched a sample of 66 children who had been given Naturalvue for 3 years from 15 practices in the US - matching here means the children had the same types of characteristics, including age. I've superimposed the result for those 66 children at the top of the graph.

More than half of children continue to experience a clinically meaningful increase in Myopia with Misight, and quite a proportion increase more than -0.25D a year. Less than 10% (6 children) increased more than -0.25D with Naturalvue over the entire 3-year period.

The Naturalvue RCT has been designed to allow this same comparison, but with the data from the RCT instead of from real-world cases.

If similar results come out of the Naturalvue RCT at the end of this year (noting 1 year results are highly correlated with 3 year results), the impact will be transformational for VTI.