EYE (ASX) Nova Eye Medical (EYE) Discussion

Originally posted by TheAnalyst007: ↑

iTrack, iTrack Advance and Omni Device Comparison

I thought I would share some procedure videos to show the difference between iTrack Advance (developed by Nova Eye Medical) and OMNI (developed by Sight Sciences). For both these companies, their MIGS devices are their primary source of revenue.

As you can see in the above chart, Sight Science's revenue has grown significantly since 2018-19 when they launched the next gen of their canaloplasty device, the Omni device. Revenue grew substantially, largely due to the fact that this device had an easy to use, handheld injector which made it substantially easier to use than iTrack (the original canaloplasty device introduced in 2008) which had a strong body of clinical evidence but required the use of forceps etc. and a substantially higher amount of training. Note that pre-Omni launch, Sight Sciences had a similar level of revenue to Nova Eye Medical. Revenue grew rapidly from US$7.5m in 2018 to US$65.5m and would likely have grown faster if it weren't for their unfortunate timing of launching just before COVID-19.Sight Sciences now has a market capitalisation of AU$760m, 25x greater than Nova Eye Medical's current market capitalisation.

iTrack (Old Device) -- Video in Link Below

iTrack ABiC - Eyetube

iTrack Advance -- Video in Link Below

iTrack Advance Training Video - Eyetube

Omni Device -- Video in Link Below
OMNI Viscodilation in a Phakic Patient - Eyetube

Discussion
There is clearly a substantial difference between the old and the new iTrack devices, with the original not having the essential handheld injector, making it extremely difficult and awkward to use. The new advances puts it on an even playing field with Omni, where the benefits of iTrack (full 360 degrees all at once, illuminated tip etc.) can be fully enjoyed by all Glaucoma doctors.

Really compare the video of the old iTrack device and the new iTrack device. Look how much easier the procedure is with the new device - it is truly like watching an old Ford vs a shiny new Ferrari! You can see the illuminated tip in both videos but for the orginal device, it is slowly and unevenly moved through the canal using forceps and other devices. It looks incredibly awkward, slow and difficult relative to other options. With iTrack Advance, the microcatheter is literally inserted and it then races smoothly around the eye (the entire 360 degrees) easily and efficiently.

Now with iTrack Advance and Omni. Really compare these two procedures (same doctor).

First, look at how difficult it is to actually see the microcatheter as it is moved through the eye. This is because of the fact that Nova Eye has patented the illuminated tip, which makes it easier to identify the location of the microcatheter, thereby reducing the risk of complications and maximising efficacy.

Also look at the difference that not being able to do the full 360 degrees in one go presents. With iTrack Advance, the injector injects the microcatheter and it zooms through the entire 360 degrees incredibly fast, with the procedure done in seconds. With Omni, the injector injects the microcatheter but it can only do 180 degrees at a time. Once it does the 180 degrees, the device is removed, visco is reaplied to the cornea (a time-consuming process) and then the device is once again re injected for the remaining 180 degrees. This is not just a longer process, but the removal and re insertion of the microcatheter increases risk of complications and reduces patient comfortability.

This is where iTrack Advance really excels. Now we have a procedure that is substantially faster, easier and smoother than the Omni device. Just comparing these procedural videos (it helps that they are all conducted by the same individual) and even someone who does not have a medical background can clearly see why iTrack Advance is such an exciting device.

@DBrent15 - keen to hear what you have to say about this analysis

Expand

Great analysis!

Clearly iTrack Advance is now the superior option for canaloplasty. This should be reflected by a significant increase in revenue once it is cleared by the FDA (which could happen as early as next week)

It is important to note as well the difference between canaloplasty (iTrack) and stent based procedures. At the moment, the vast majority of operations are performed using stents or shunts (think iStent by Glaukos, or the Hydrus device). These have always been quick and easy (and quite effective) however there are still a number of important flaws which could drive a shift from these procedures to canaloplasty. A stent is literally a small piece of metal that is inserted in the eye and left there, thereby (unnaturally) unblocking the canal and relieving pressure. There are several issues with this type of procedure:

It is difficult to determine where the blockage is, meaning stents are often incorrectly placed. This requires that they are removed (a long procedure in itself) and reinserted (again, a further annoyance for patients). This is not an issue for iTrack as it treats ALL points of resistance!
There are also typically multiple locations causing IOP issues, meaning that whilst a stent may relieve one source of the elevated IOP, it can fail to target all potential points of resistance (canaloplasty targets all points of resistance)
The idea of leaving a stent in your eye is often daunting for many patients, whereas canaloplasty leaves nothing behind and is naturally reducing IOP.
Stents have a higher risk of bleeding as well as causing more endothelial cell loss compared to canaloplasty.
Recent changes to the CPT codes in the US for canaloplasty and stents means that canaloplasty is a cheaper procedure, making it more appealing to Drs and patients especially as the cost of living continues to rise.

Also note the fact that Drs are increasingly combining canaloplasty and stents which could present a huge opportunity for iTrack Advance to really accelerate sales growth (could also lead to increased M&A activity in the space)