At the moment it is something like that, as canaloplasty is...

At the moment it is something like that, as canaloplasty is still quite a young market. I am more focused on the total glaucoma treatment market. I believe something like 80 million people have open angle glaucoma, and around 30 million have closed angle (which iTrack Advance is unique in being able to treat). Importantly, these people tend to be from developed countries (meaning they can afford treatment). At the moment drugs make up the vast majority of the total treatment market, generating billions per year. However, as we all know, compliance is very low (around 90% of people do not follow instructions and around 50% completely stop taking the drops altogether within 6 months¹), side effects such as ocular surface disease are common, and they can be quite expensive/inconvenient. Previously this was the only option as traditional surgery was far too risky to attempt at an earlier stage. However, MIGS presents an opportunity to intervene earlier on. Most doctors are still stuck in the mindset that drops must be done first, but there is a growing movement to practice what is called interventional glaucoma management, which involves using MIGS at the beginning.

Canaloplasty via iTrack Advance makes more sense as a first line treatment than stents, as patients who have only recently been diagnosed would definitely prefer maintaining the physiology of their eye, as opposed to implanting a stent or permanently tearing the canal. Moreover, the recent change in reimbursement last year significantly favours canaloplasty now, which should help with encouraging doctors to shift from stents to canaloplasty. So whilst there is money to be made in the existing MIGS market, I think the real opportunity will be the increasing popularity of interventional glaucoma management resulting in a shift from drugs to MIGS. The cataract surgery market is even larger, something around $10 billion per year if I remember correctly. Even if we capture 10-20% of that market there is also enormous potential there.

The global market will take more time to fully penetrate, but most of the money is in the USA so that is the best place to focus. Unfortunately (for us, not the company), Australia is probably very low on their priority list. Many more much larger markets to penetrate first.


(1) Nordstrom BL, Friedman DS, Mozaffari E, Quigley HA, Walker AM. Persistence and adherence with topical glaucoma therapy. Am J Ophthalmol. 2005 Oct;140(4):598-606.