Meeting Challenges Through Innovation

ESCRS iNovation Day 2025 featured another exciting Innovators Den, a competition for ophthalmic entrepreneurs developing new devices and treatments to improve eye care. Out of dozens of competitors, three finalists selected by a panel of judges made pitches to an international audience of ophthalmologists, investors, and industry leaders in bids for partnerships to help bring new products to market.

One would be chosen the winner of the 2025 Innovators Den medal. Should they complete the arduous path to market, their innovations could significantly contribute to patient care.

Titratable filtration

Treating glaucoma with tubes is challenging in part because post-surgery aqueous outflow rates are not entirely predictable. Existing devices aren’t adjustable after surgery, which can cause problems—including an immediate excessive outflow after surgery and a later under-filtration. Titran, a glaucoma titratable device in development by Bellagio Medical, will help meet the challenge, Paolo Cecchini MD, PhD said.

Instead of relying on a fixed lumen diameter and length to control flow rates, Titran uses multiple filtration holes in its tube. Filtration is set at a zero or minimal rate at implantation,
and a YAG or thermal laser can be used at the slit lamp to increase outflow by opening new holes of different diameters.

Sequential activation allows the conjunctiva to heal, reducing the risk of aqueous leaks, hypotony, athalamia, and choroidal detachment, Dr Cecchini said. The new titratable filtering system allows for increasing the outflow months or years later if IOP rises.

“This allows early and late titration for each and every patient,” he said. “The surgeon decides when to open new filtration holes, where to open them, and how much filtration
is needed for that specific patient.” 

With global glaucoma device sales approaching $1.8 billion in 2024 and expected to hit $2.8 billion by 2034, Dr Cecchini envisions a big market for Titran. Bellagio Medical seeks $2 million in seed funding to develop the existing prototype and conduct initial human trials.

Dislocated IOL rescue

With populations ageing worldwide, dislocated and subluxated intraocular lenses (IOLs) are becoming more common, particularly in post-trauma cases or after complicated cataract surgeries. The Oseguera Ring can help rescue virtually any type of dislocated lens, including simultaneous vision lenses and other premium IOLs, in just a few minutes—without unnecessary explants.

In many cases, this can reduce the cost, complexity, and risk of existing rescue techniques, which may require challenging special sutures, backup lenses, or even a second surgery, said inventor Gerardo López Oseguera MD. “It complements rather than replaces the other techniques.

Developed by Eyedictive, the Oseguera Ring is a universal, sutureless, scleral fixation device designed for affordable and accessible lens rescue. It offers secure, centred IOL fixation and can be readily kept on hand even in resource-challenged sites, Dr Oseguera said.

Compatible with most IOLs, including one-piece and threepiece lenses, the device features two anchors that are inserted into scleral incisions supporting a central double ring. The rescued lens is inserted between the rings, which centre the optic. The off-axis anchors counter-tilt and improve stability, Dr Oseguera said.

Dr Oseguera estimates that secondary fixation is required in about 1–2% of 28 million cataract cases per year globally, or about 500,000 cases. Eyedictive seeks €500,000 to develop industrial tooling to produce the ring and support regulatory certification, an initial production run, and pilot clinical. 

“Let’s make IOL rescue accessible to every surgeon, everywhere,” Dr Oseguera said.

Regenerating retinas

Age-related macular degeneration (AMD) is a progressive disease that can be slowed, but not reversed, with existing injection and photobiomodulation (PBM) therapies. Adding quantum molecular resonance (QMR) technology may have a regenerative effect. Resono Ophthalmic is now developing a combined QMR and PBM treatment for dry AMD, said Alessandro Pozzato MSc.

Indeed, results from a pilot study show QMR alone improved visual acuity and microperimetry sensitivity and slowed progression to wet AMD in patients with dry AMD.¹

The treatment activates the body’s regenerative capacity by applying low-intensity, high-frequency electric fields over several sessions, Pozzato said. This technology interacts with the biological tissue to reduce inflammatory cytokines and release anti-inflammatory cytokines, stimulating stem cells to regenerate tissue, he explained. QMR already is available as a dry eye treatment.

Combining QMR with PBM has a synergistic effect that could make it an attractive option for many of the more than 200 million AMD patients worldwide. Resono has developed a device and mask with single-use pads that integrate the two technologies for in-office treatment. The firm is now moving to conduct a pivotal study, marketing and consultancy, certifications, and industrialisation.

“The future of medicine is regeneration,” Pozzato said.

And the winner is…

After careful deliberation, the judges named Dr Cecchini’s Titran device the winner. But all Innovators Den participants benefited from expert mentoring and from developing valuable financing and industry contacts that will help transform insightful ophthalmology therapy ideas into commercial products that can improve patients’ lives.

All comments were made during iNovation Day at the 2025 ESCRS Annual Congress in Copenhagen.

Paolo Cecchini MD, PhD is medical director at Clinica Baviera, Milan, Italy, and co-founder of Bellagio Medical, Titran, a new titratable glaucoma device.
paolo_cecchini@yahoo.com

Gerardo López Oseguera MD, MBA, IB is a certified ophthalmologist and vitreoretinal fellow at IMO Groupo Miranza, and a biomedical engineer and founder of Eyedictive, a medtech company, both in Barcelona, Spain.
drlopezoseguera@gmail.com

Alessandro Pozzato MSc, MBA is an engineer who is director of research and development at Telea Medical, and executive board member of Resono Ophthalmic
SRL, both in Sandrigo, Italy. contact@resono.it, alessandro.pozzato@resono.it 

1. Scalini SZ. Invest Ophthalmol Vis Sci, 2025; 66(8): 691.