Alcon to acquire Optonol

After decades of providing pharmaceutical treatment options for glaucoma, Alcon Laboratories, Fort Worth, TX, plans to add a surgical treatment option by acquiring Optonol Ltd., Israeli manufacturer of a proprietary mini-glaucoma shunt (Ex-PRESS).

Terms of the deal, announced Dec. 13, were not disclosed. The acquisition is expected to close by the end of March, following regulatory approval.

The shunt, a tiny, tubular device that is implanted under a scleral flap to divert the aqueous humor from the anterior chamber to the subconjunctival space, has been shown to reduce IOP effectively in patients with open-angle glaucoma and ocular hypertension. Ophthalmologists typically recommend the device for patients who have exhausted pharmaceutical efforts to control IOP.

Iqbal "Ike" K. Ahmed, MD, a glaucoma specialist in private practice in Toronto, Ontario, said the mini-glaucoma shunt is an effective procedure to lower IOP, with what appears to be reduced complications. Dr. Ahmed, who also is an assistant professor at the University of Toronto, Department of Ophthalmology and Vision Sciences, said he prefers the shunt over trabeculectomy because there is no need for an iridectomy, which can result in additional complications such as hyphema and inflammation, and because the mini-glaucoma shunt insertion procedure requires only a microincision that maintains the stability of the anterior chamber intraoperatively.

"As far as efficacy is concerned, there's no debate that this procedure is on par with the known IOP-lowering effect of trabeculectomy, especially when combined with mitomycin-C," Dr. Ahmed said. "It's very rare to have the chamber collapse." Small landmarks make insertion "very predictable," he added.

Although there are other companies with surgical devices to treat glaucoma, Optonol is a good fit for Alcon because its product is already approved and established, and Medicare and many other major carriers provide reimbursement, Warner added. Medicare has provided reimbursement since July 1, 2008.

According to Alcon, there were 325,000 glaucoma surgical procedures worldwide in 2009. That number is expected to climb to 500,000 procedures by 2018, according to a Dec. 14 Collins Stewart analyst report.

"It is experiencing very good growth in the market and, with Alcon's commercial capabilities behind it, we can accelerate that growth and get this technology better understood by physicians for the benefit of their patients," Warner said.