Market Scope: Phaco and FLACS Upgrades to Drive Expansion in Cataract Equipment Market

A number of market leaders in phaco and femtosecond cataract technology will launch upgraded platforms over the next year, which is expected to increase market penetration for both types of systems and stimulate the replacement of older models.

Johnson & Johnson Vision has introduced its Veritas ultrasonic phaco (USP) machine, while Bausch + Lomb, BVI, Dutch Ophthalmic Research Center (DORC), Hoya, and Oertli each are in various stages of offering upgrades to their phaco platforms.

Among companies enhancing their femtosecond laser-assisted cataract surgery (FLACS) systems, Lensar is planning to roll out the first combination FLACS/USP machine, called the Ally, in early 2022, while Bausch + Lomb, J&J Vision, and Ziemer are introducing significant platform upgrades.

Market Scope’s “2021 Cataract Surgical Equipment Market Report” looks at how these improvements will expand market share.

Ultrasonic phaco currently accounts for nearly 70 percent of global cataract procedures, while FLACS plus phaco represents only 3 percent. Manual procedures make up the remainder.

Market Scope looks for phaco’s penetration to increase to more than 72 percent by 2026, with FLACS plus phaco rising to nearly 4 percent. Growth in phaco and FLACS market share as new platforms are introduced will expand sales of consumables.

In addition, worldwide growth in cataract surgery will boost sales of consumables and user fees, which collectively will account for 65 percent of revenue in 2021. Market Scope projects that the number of cataract and refractive lens exchange (RLE) surgeries will grow from 29.8 million to nearly 37 million over the next five years at a compound annual growth rate (CAGR) of 4.3 percent.

Phaco consumables consist of phaco packs, ultrasonic handpieces, tips, sleeves, and other accessory items. FLACS consumables include user fees and single-use procedure items.  

Ultrasonic phaco is considered the gold standard in cataract surgery in wealthy countries, but penetration has been more limited in developing countries where surgery cost is a more important factor.

Machine manufacturers address these cost concerns by offering less expensive versions. Market Scope’s new report describes three levels of ultrasonic phaco machines and how demand is shifting for each in different regions of the world based upon the needs of cataract surgeons and their patients.

In 2020, COVID-19 reduced global cataract surgery by 25 percent, creating a backlog of over 6.4 million cataract procedures, largely due to shutdowns in elective procedures as countries conserved medical resources and tried to limit the spread of the disease.

The pandemic is expected to accelerate changes in the way cataract surgery is performed over the next 5 years, including the adoption of office-based cataract surgery (OBCS) and immediate simultaneous bilateral cataract surgery (ISBCS).

FLACS laser sales have declined in recent years, while FLACS procedure volume has continued to grow. Improvements in the technology—a trend now underway—and changes to the business model are required to increase the limited market penetration.

Market Scope looks for the cataract surgical equipment market to grow from $1.6 billion in 2021 to $2.1 billion in 2026, at a CAGR of over 5 percent.

More than 30 companies offer cataract equipment products, but the market has been dominated by three large participants—Alcon, J&J Vision, and Bausch + Lomb—each with broad product lines and direct global sales coverage in major markets.

Together, these three leaders account for nearly three-quarters of market revenue, while the more than 30 smaller participants tend to concentrate on certain regions and more limited product offerings. Oertli, Nidek, Lensar, Ziemer, and Carl Zeiss Meditec are the largest of these companies.

Market Scope’s “2021 Cataract Surgical Equipment Market Report” was published in July.