Bausch + Lomb Spotlights BL 1107 Eye Drop and ELIOS Implant-Free Laser as Glaucoma Catalysts

Key Points

• BL 1107 is a next‑generation, alpha‑2B‑selective prodrug designed to lower IOP and provide neurofunctional benefit—clinical proof‑of‑concept showed IOP lowering plus "15‑letter" visual gains and improved visual field versus timolol; a ~159‑patient Phase II readout is expected in the second half of the year with Phase III potentially starting soon and a standard NDA timeline previously communicated to 2031.
• ELIOS is an implant‑free excimer laser MIGS procedure that met pivotal U.S. endpoints with sustained >20% IOP reduction at two years, an average 7.4 mmHg unmedicated IOP drop, and >80% of patients medication‑free; Bausch + Lomb expects U.S. approval in H2 2026 and initial P&L impact beginning in 2027 with a ramp into 2028.
• Bausch + Lomb is positioning glaucoma as a chronic neurodegenerative disease with a major unmet need for neuroprotection, prioritizing differentiated technologies (BL 1107's vision focus and ELIOS's implant‑free approach) and saying reimbursement for ELIOS is not expected to be a barrier.

Bausch + Lomb NYSE: BLCO highlighted two glaucoma programs during a Wells Fargo-hosted “2026 MedTech Innovation Spotlight” call, focusing on BL 1107, a next-generation alpha-2 agonist eyedrop, and ELIOS, an implant-free excimer laser procedure designed to lower intraocular pressure (IOP) during cataract surgery.

Management framed glaucoma as neurodegenerative disease with unmet need

Executive Vice President of R&D and Chief Medical Officer Dr. Yehia Hashad described glaucoma as a chronic neurodegenerative condition in which elevated IOP is a key risk factor, but not the sole driver. He said some patients can experience neurodegeneration despite “normal” IOP, contributing to a shift in how the disease is defined and managed.

Hashad emphasized that glaucoma often progresses slowly and can go undetected until meaningful damage has occurred, noting patients may not recognize symptoms until “about 40%–60%” of neurodegeneration has already happened. He said the goal is earlier intervention, aided by diagnostic tools that can identify anatomical changes before functional vision changes. He also described neuroprotection as a major unmet need, particularly because clinicians cannot reliably predict which patients will progress to severe visual impairment.

BL 1107: next-generation alpha-2 agonist aimed at vision and IOP

Senior Vice President of Pharmaceuticals and Consumer R&D Dr. Mayssa Attar positioned BL 1107 as a therapy intended to address both IOP and glaucoma’s neurodegenerative component. She said preclinical and clinical data suggest alpha-2 adrenergic agonists may help treat injured cells before damage becomes irreversible, citing prior findings from the LoGTS study in which brimonidine-treated patients were less likely to develop visual field loss than timolol-treated patients even when IOP reduction was similar.

Attar said BL 1107 is designed as a prodrug to deliver active drug deeper into ocular tissues, including the retina. She also highlighted receptor selectivity: BL 1107 was described as more selective and potent for alpha-2B receptors, while brimonidine is more selective for alpha-2A. Attar said alpha-2B is widely expressed in the retina, where the company wants the drug to act to “improve and protect vision.”

On clinical proof-of-concept results, Attar said BL 1107 demonstrated IOP lowering and, “for the first time,” clinical data showing 15-letter gains under low-light conditions. She called 15-letter gains an approvable endpoint and said BL 1107-treated patients also showed statistically significant improvement in visual field mean deviation versus timolol by day 14. In Q&A, management discussed how such changes could occur quickly, describing “neurofunctional enhancement” as restoring function in stressed-but-not-dead cells, with longer-term dosing potentially supporting neuroprotection.

The company said a larger Phase II trial is ongoing, described as a randomized, double-masked, parallel-group study with approximately 159 patients, designed to replicate proof-of-concept findings with refined elements including powering for vision endpoints. Management expects a readout in the second half of the year, with Phase III potentially beginning “within a quarter or two” after the readout.

On regulatory and timing considerations, the team said they expect to pursue a standard new drug application pathway and may consider seeking Breakthrough Therapy designation depending on the Phase II data. They said they have previously communicated a timeline of 2031 under a normal pathway, and suggested Breakthrough designation could potentially shorten timelines, including a faster FDA review cycle and possibly fewer pivotal trials.

Attar also noted work on a sustained-release formulation, describing early data as “very promising” and supportive of entering development at the end of 2026, and referenced a partnership with Ripple for long-acting injectables. Management also pointed to broader potential indication expansion opportunities, including retina, contingent on further data.

ELIOS: implant-free excimer laser MIGS approach with pivotal data

Senior Vice President of Surgical R&D Dr. Kelly Swaim and strategic medical advisor Dr. Cathleen McCabe discussed ELIOS in the context of minimally invasive glaucoma surgery (MIGS), particularly procedures performed alongside cataract surgery. McCabe said MIGS has been a “game changer” in treating cataract patients with glaucoma by improving quality of life and potentially reducing progression risk through IOP management and reduced medication burden.

ELIOS uses an excimer laser to create 10 microchannels in the trabecular meshwork, aiming to improve outflow while preserving tissue. Swaim and McCabe emphasized differentiation versus implant-based MIGS approaches, arguing that an implant-free procedure may reduce risks tied to device placement and could lower barriers to adoption for cataract surgeons who have been hesitant to leave an implant behind.

The company highlighted positive results from a U.S. pivotal study announced that morning, stating the study met primary endpoints. Swaim said the data showed sustained IOP reduction of over 20% over two years and a reduction in medication burden with over 80% of patients medication-free. She also provided additional metrics during Q&A, including an average 7.4 mmHg decrease in unmedicated diurnal IOP, a reduction in average medications from 1.5 at screening to 0.3 at 23 months, and no intraoperative complications, with a postoperative adverse event profile described as similar to cataract surgery alone.

McCabe pointed to European experience, saying there are eight years of long-term data supporting durability. She also said some other MIGS datasets extend to five years, making eight-year data meaningful in her view.

Timelines, reimbursement comments, and commercialization expectations

Bausch + Lomb reiterated expectations for U.S. approval of ELIOS in the second half of 2026. The company said the current focus is use in combination with cataract surgery, with standalone use described as a potential future development area but not currently planned.

Management also addressed reimbursement at a high level, saying ELIOS has a procedural code and that reimbursement is not expected to be a barrier, though they deferred details given the R&D focus of the call.

On commercialization, one executive said they expect ELIOS to begin impacting the P&L in 2027 and “ramp nicely” into 2028, adding that the learning curve described by McCabe could support faster adoption than some other MIGS procedures.

In closing remarks, Hashad said the company is targeting areas of high unmet medical need with differentiated technologies, pointing to BL 1107’s dual focus on IOP and neuroprotection and ELIOS’s implant-free approach as examples of that strategy.

About Bausch + Lomb NYSE: BLCO

Bausch + Lomb Corporation operates as an eye health company in the United States, Puerto Rico, China, France, Japan, Germany, the United Kingdom, Canada, Russia, Spain, Italy, Mexico, Poland, South Korea, and internationally. It operates in three segments: Vision Care, Pharmaceuticals, and Surgical. The Vision Care segment provides contact lens that covers the spectrum of wearing modalities, including daily disposable and frequently replaced contact lenses; and contact lens care products comprising over-the-counter eye drops, eye vitamins, and mineral supplements that address various conditions, such as eye allergies, conjunctivitis, dry eye, and redness relief.

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