“I do see a bright picture”

Exploring technology, addressing comfort and helping practices build back from COVID-19 appear to be key focuses for Alcon this year.

The topic of comfort in particular was a core area of discussion from Alcon at the BCLA’s Virtual Clinical Conference and Exhibition 2021 in June. During the event, Alcon presented data from studies on its Total30 lens, a product described as the ‘first and only monthly replacement water gradient contact lens.’ The contact lens is expected to be introduced into the US and select European markets in 2021, with a broader rollout planned for 2022.

Following the event, OT spoke with Andy Pawson, Alcon Global Vision Care president and general manager, to find out more about the Total30 design, the company’s key focuses for 2021 and the performance of the contact lens market.

What can you tell us about the Total30 monthly water gradient contact lens?

Firstly we need to address – why innovate in the reusable segment? It is a really important part of the market, with about 45% of sales value globally in the contact lens world in the reusable segment. But that doesn't really give the full picture because of the pricing differential. Actually, more than 75% of contact lens wearers in the world are in a reusable segment. It's a sizable part of the market that's not really had much innovation and has been a little bit neglected. Everyone has been pretty focused on the growth of daily silicone-hydrogel lenses.

In a market like the mature US market, 60% of new contact lens wearers come into the category in reusables and about seven out of 10 stay in that segment. It's a crucial part of the contact lens business and portfolio and if we're going to best meet patient needs, we need to be innovating in all parts of the portfolio. That's why we decided to focus our next innovation on reusables.

Then, there is still a sizable amount of patients who drop out of contact lenses because of a lack of comfort. About 20% of new contact lens wearers drop out within the first year, many in the first month or so.

We set out to take what we believe is the best-in-class comfort level with Dailies Total1, and gave our research and development team the challenge to reproduce that performance for 30 days in a reusable lens.

Some years on, we’ve managed to crack the code. We’ve taken the essence of the water gradient that is featured in Dailies Total1, but added a biomimetic surface technology that actually mimics the surface of the cornea. The contact lens is durable – you can clean it for 30 days and it will perform day after day, and it is also very resistant to bacteria and lipid deposits because of its unique surface chemistry.

How much of an issue do you see comfort still holding for contact lens retention? How can this be addressed?

Comfort is important throughout the contact lens wear journey, especially as a new wearer, where there can be a lot of initial anxiety about putting something in your eye.

One of the things that we’re very keen on is innovating in how eye care professionals can engage more with the patient using technology – things like digital technology and telemedicine tools to engage in contact lens aftercare. It’s important in those early days to coach a patient through that journey, but it also remains important thereafter.

Beyond that, there is the evolution and increase in the number of symptomatic contact lens wearers who have dry eye – 1.8 billion sufferers of signs and symptoms of dry eye around the world – or who suffer from allergies. That can cause patients to re-evaluate their choice of vision correction and how they go about looking after their vision.

Comfort is also still probably up there as a number one or two reason for presbyopia dropouts at the end of the life cycle of wear. That remains a huge opportunity because our research suggests that patients still want to be spectacle independent, and presbyopia gets in the way. Multifocal lenses and progressive spectacles do provide a solution on the onset of presbyopia, but at a certain point in time, when the add power gets too high, you start to see a little bit of compromise in distance to near vision.

Comfort and visual acuity combine to create significant drop-out in the 40 to 50 years of age range. If we could change that trajectory by just one or 2% by providing a better lens wear experience, by improving visual acuity or providing an even higher level of comfort, then that's not only a great commercial opportunity, but it is also a great opportunity for patients.

Those are things that we're looking to address and we're investing in a lot of new technology to try to create a presbyopia breakthrough.