Before ReVision Optics closed for business in late January, opting to use what monies it had on two months’ worth of employee salaries after fighting for its financial life, here is what I had written for my stint as guest editor (Just a few sentences):

“We are about to enter a new age of lens-based eye surgery ... Recent advancements in perioperative diagnostics and surgical technology have improved the accuracy and precision of lens-based surgery, but it appears these technologies have not quite hit the mark: Many surgeons are choosing not to provide and/or patients are not opting to take advantage of current offerings. Much of the hesitation on the surgeons’ part stems from fear of failure to meet desired outcomes.”

Obviously, it is more than that. There is a sobering financial element to refractive surgery, not only from the patient’s vantage point, but also from the surgeon’s.

This was an innovative product, and 90 surgeons had trained to implant the Raindrop since its approval in 2016. But, as ReVision’s Sarah Cannon told OM, not enough were implanting 30 or more a month. Upon hearing of Revision Optics financial demise, many surgeons spoke their mind at meetings and online chat groups. Chuck Williamson’s perspective summed up the situation nicely as he wrote:

“A number of surgeons found ways to expand patient selection for Raindrop, and had good results with it ... I did not learn to implant the Raindrop because its business model, like those of many new refractive procedures, is not sustainable on a significant scale.

“That’s not to say the newly approved RxSight light-adjustable IOL or the in-clinical trial ClarVista Medical Harmoni exchangeable lens platform shouldn’t be designed. They should. We gain different skills each time a new refractive product is released.

“Someone once said to ‘succeed in business you simply have to find out what people want to buy and sell it to them at a price they’re willing to pay.

“But industry has yet to come up with what these patients want: distance and near in both eyes with nary a problem. No pinholes. No cornea shape-changing. While some are willing to accept a hybrid of that for now, they do not number enough to keep the ReVision Optics of our world from crashing.

“I applaud Allotex, Rain-drop, Kamra (AcuFocus) and so on, just like I applauded conductive keratoplasty. Some will survive in some form, and some will not.

“So, we should keep forging on. Learning as we go. Some of us will alternately sometimes cheer and sometimes suit up and get in the game. The marketplace will take its toll.

“As long as we all face reality: the companies, investors, engineers, patients and the surgeons all have different expectations and motivations. The people in each category will have to do their job and make decisions as best as they can.

“Maybe this is how things are supposed to be. Good job, RVO. You went down fighting.

Next.” OM

William F. Wiley, MD, is medical director of Cleveland Eye Clinic and Clear Choice LASIK Eye Center in Cleveland, Ohio. Contact him at Wiley@cle2020.com.

Charles H. Williamson, MD, is the medical/surgical director of the Williamson Eye Center. He is the second generation of eye doctors in a family that has taken care of eyes of Baton Rouge, La., families. Dr. Williamson helped develop clear corneal cataract surgery under topical anesthesia, which is now the technique most often used throughout the world. A noted author, Dr. Williamson has published a number of articles and monographs and contributed to textbooks on both cataract and refractive surgery.