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Alcon pays $199M to settle femtosecond laser cataract surgery claims

14 Feb 2023

Pending legal dispute with Johnson & Johnson division resolved with payment and cross-licensing deal.

Swiss eyecare giant Alcon has agreed to pay rival Johnson & Johnson (J&J) $199 million as part of a legal settlement surrounding the use of femtosecond lasers in cataract surgery.

The Geneva-headquartered company said that the deal would resolve pending legal proceedings involving J&J’s Surgical Vision business.

Both companies gained their ultrafast laser technology expertise with major acquisitions several years ago - Alcon through its $744 million buy-out of startup LenSx in 2010, and J&J via its 2017 deal to acquire Abbott Medical Optics. Abbott had previously bought OptiMedica for $400 million in 2013.

In a brief statement, Alcon announced: “As part of the resolution of this matter, the parties have exchanged cross-licenses of certain intellectual property and other mutually agreed covenants and releases, and Alcon will make a one-time payment to J&J Surgical Vision, Inc. of $199 million for those rights and to resolve various worldwide intellectual property disputes relating to this matter.”

FLACS: less cost-effective?
Developed in the early 2000s, femtosecond laser-assisted cataract surgery (FLACS) emerged as one of the first major commercial markets for ultrafast sources the following decade when regulatory approvals were granted in Europe and the US.

Aside from the Alcon and Abbott acquisitions that followed, Bausch & Lomb paid $450 million to acquire Technolas Perfect Vision - with the totals involved indicating the huge size of the potential market for cataract procedures.

The technique is now widely used in cataract procedures, for key steps like making precise incisions into the patient’s lens, and softening the cataract through phacofragmentation.

Traditional phaco surgery uses ultrasound to break up the crystalline lens that has hardened into a cataract, and FLACS was expected to offer an improvement. In 2018, Alcon said that its LenSx system passed the milestone of performing one million cataract surgeries in the US.

However, reports on the cost-effectiveness of the technique are mixed. In a review published in August 2022, the American Academy of Ophthalmology (AAO) found that FLACS and conventional phacoemulsification cataract surgery (PCS) were both safe and had excellent outcomes, but that FLACS was more expensive.

The AAO authors did find that FLACS might be more beneficial in certain cases, for example those involving a trauma his­tory or other conditions that make it crucial to preserve endothelial cells, and to correct corneal astigmatism.

“Both FLACS and PCS have similar excellent safety and refractive outcomes,” they concluded. “At this time, one technique is not superior to the other, but economic analyses performed in some populations have shown that FLACS is less cost-effective.”

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