PC-IOL Demand Rises Modestly, Soars in a Few Countries

Presbyopia-correcting IOLs experienced steady global growth in 2021 and record-breaking growth in a handful of countries, according to a Market Scope report.

PC-IOLs accounted for nearly 1.65 million cataract and refractive lens exchange procedures in 2021, and 6.3% of all IOLs, compared with just 575 thousand surgeries in 2011, and 2.6% of all IOLs.

Top factors driving PC-IOL growth are improvements in PC-IOL technology, growing public awareness of the value of spectacle independence, and favorable reimbursement provisions.

The growing availability of trifocal and extended depth of focus (EDOF) designs, which accounted for nearly 80 percent of all PC-IOLs in 2021, has given cataract patients an array of options, from complete spectacle independence with some optical disturbances, to somewhat less spectacle independence with fewer optical disturbances.

More IOL companies now offer trifocal IOLs, including Alcon (PanOptix), Bausch + Lomb (enVista), BVI (FineVision), Carl Zeiss Meditec (AT LISA trifocal), Rayner (RayOne Trifocal), and VSY Biotechnology (Acriva Trinova Pro).

Various types of EDOF diffractive and non-diffractive IOLs are also available, including the Alcon Vivity, Bausch + Lomb LuxSmart, Carl Zeiss Meditec AT LARA, J&J Vision Tecnis Symfony, and SIFI Mini-Well Ready.

In addition, companies have introduced combination multifocal and EDOF designs, such as the BVI FineVision Triumf, Cristalens Artis Symbiose, and J&J Vision TECNIS Synergy.

Growing public awareness of improved spectacle independence with PC-IOLs has been a growth driver in many wealthy countries, where cataract surgeons are able to advertise the advantages of PC-IOLs to their patients.

Testimonials from satisfied cataract patients has helped increase PC-IOL awareness, too. However, adoption has been minimal in markets lacking a reimbursement provision that allows cataract patients to pay the added cost for the PC-IOL over a monofocal IOL without having to pay for the entire cost of the cataract surgery and PC-IOL.

Paying only the difference in IOL cost is often referred to as balance billing. In many countries, including Japan and most European countries, paying for the cataract procedure and premium IOL puts the surgery out of reach financially.

There were large differences in the penetration of PC-IOLs in wealthy countries compared with less developed ones in 2021. It was typically less than 2% in poorer countries, while it exceeded 10% in seven wealthy nations: the US, Australia, Brazil, Romania, South Korea, Taiwan, and Turkey.

The US, where the penetration exceeded 10% for the first time in 2021, accounted for more than 28% of global PC-IOL procedures.

Market Scope’s “2022 IOL Market Report” addresses an array of technologies that are expected to help drive PC-IOL growth to nearly 2.6 million units and revenue of nearly $2.0 billion by 2027.

They include refinements in trifocal and EDOF IOL designs, paired PC-IOL designs for bilateral cataract patients, next-generation shape-changing accommodating lenses, and customized EDOF post-op adjustable IOLs. Market Scope projects PC-IOLs will account for over 24 percent of revenue by 2027.

Overall, Market Scope looks for premium IOLs—including PC-IOLs, toric IOLs, post-op adjustable IOLs, and phakic IOLs—to account for 48% of global IOL revenue by 2027.

Market Scope’s “2022 IOL Market Report” was published in April.