Three OIS Podcast Hosts Put the Ophthalmology Innovation Year in Review in Perspective


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The annual tradition of the “Ophthalmology Innovation Year in Review” continues for 2021 with data on National Eye Institute funding, venture deals, public offerings, merger-and-acquisition transactions, Food and Drug Administration approvals, and Phase III trial readouts.


In this OIS Podcast, OIS Co-founder Craig Simak switches seats with three of our podcast hosts—Firas Rahhal, MD, Robert Rothman, MD, and Ehsan Sadri, MD. The three wisemen, who also happen to be venture capitalists, reflect on some of the more notable events from the “OIS Year in Review” presentation while providing commentary and insights on what the data means for industry, physicians, investors, and even patients. Be sure to listen in to the last podcast for the year and download the full report.


Click “play” now.




Craig Simak: Welcome, everyone. This is the OIS Year in Review Podcast for a change. I get to interview three of our hosts today. We have Firas Rahhal, who is a well-respected Retina Surgeon, also a Managing Partner with ExSight Ventures, also we have Rob Rothman, who’s a local friend on Long Island, also Glaucoma Specialist, and a Partner with InFocus Capital. And then we have Dr. Ehsan Sadri, who is in Newport Beach, California, the founder of Visionary Eye Institute, and also a Founding Partner of Visionary Ventures. So gentlemen, thank you so much for joining me today, on a Sunday morning, no less to take a look at the Year in Review data that we pulled together with the help of some of our good friends at Piper Sandler, Regulatory Pathways Group, GRA Group, the US FDA, and the National Eye Institute. So just real quickly wanted to get some thoughts from each of you on, at a high level on some of the data. We’ll just run through the presentation, everyone will have the opportunity to download the slides and go through it on their own, but thought it’d be interesting to get perspectives from our hosts today, being natural physicians and involved in funding startups.

Ehsan Sadri: It’s an honor to be here with Rob and Firas for me personally, it’s a learning opportunity for me, you know, I don’t dive too much into the retina. So I’m really curious about what Firas gonna teach me today. So I’m humbled and thankful, it’s been a great, weird year for us with us, all three of us see patients still, and it’s good to see everybody back in, you know, at the Academy, at least in person. And I’m glad things will open up. So and I’m glad you’re doing this because I think it serves a lot of purpose for a lot of folks that, you know, probably don’t know, as much data as my brother’s here, as far as the venture groups go. But you know, it’s an honor to be here. For me personally, what you’re saying with this slide is basically what we’re just talking about is, you know, a year, your NEI basic research, funding is strong, it’s steady. And then we were talking offline about how private funding is probably just as strong but much bigger as a pie. And so for me, personally, what this means is ophthalmology research and venture group is it’s continuous. And it’s exciting. And I think there’s a lot more investments coming.

Craig Simak: Cool. Well, now let’s take a look real quick at some of the venture funding activity. So I mean, lots of deals, still, you know, more so in pharma, which is no surprise than med tech. But there’s a lot of money being put to work in a number of companies, we’ll look a little bit later I’d add, like what phase of development there advocate clinical trials.

Rob Rothman: So Craig, it’s important to realize, yeah, it’s also important to realize, when you look at this slide, this is just a small segment of what’s actually been funded, right. You know, there are dozens, or maybe even hundreds of additional companies that are not listed on this slide, who have received funding, you know, not only from the three groups that are represented on this call, but from other sources of capital, these are the large, you know, VC deals that have occurred, but, you know, the InFocus, for example, has, you know, 13, portfolio assets that are not represented up there at all that are, you know, kind of some of them are clinical stage at the moment, and some of them are generating revenue and whatnot. And I think the size of the deals will change. I know, the investments from Visionary and ExSight. And, you know, we’ve all taken, you know, swings on different levels of funding. So this slide is just a tiny fraction of what’s actually been funded over the course of the year. And another point just to make, so that everybody knows it is a Sunday and Firas is not actually working, even though he’s in the office, just making sure people. He’s gonna make the rest of us look very bad. But you know, just clearly.

Firas Rahhal: The next retinal detachment is right around the corner. You never know. I’m always working. Actually Rob, I sit here seven days a week just waiting for them to come in. I don’t even, I appreciate your comments about, I don’t delve too deep in the retina, I was thinking as a clinician, as a surgeon this is a good thing for you. You don’t want to be delving too deep back there when you’re taking out your cataracts and stuff.

Ehsan Sadri: The only comment here I would say is, you know, to Rob’s point, I think you have a lot of other activities. But I think this is a good slide that kind of talks about what are some of the salient things that have occurred. I can only comment on myopia management that we lead a deal. And CINDEX as you know, here based in San Diego, you know, and I think, you know, we’ll talk about later but myopia, presbyopia, there’s a big, big sort of unmet needs in our field. For right now, at least when it comes to add to your segment. So, you know, there’s a tremendous amount of activity can kind of see this, their competitors of, you know, AbbVie, you know, presbyopia correction here. So there’s you can see that what I take away the takeaway from this slide is there’s multiple partners and competitors in spaces that are unmet, and there’s plenty of business for everybody.

Firas Rahhal: Yeah, I agree. And then also to add to that, in another sort of, broad statement that shows the diversity here of different companies, different concepts, you see how fertile the ophthalmology spaces, you have everything from dry eye to devices for diagnosis to gene therapies and regenerative medicine in the posterior segment to even a device that creates an eye drop more effectively, that the types of investment in ophthalmology are vast and diverse. And strangely enough, you can diversify within such a narrow scope of ophthalmology, reasonably well as an investor, early, late, mid in staging and all these different parts of the eyes and all these diagnostics and therapeutics. And here, you see that there’s a wide range here of different disciplines.

Rob Rothman: Yeah. And, not to harp. And I’m sure that both Firas and Ehsan had been through this, as you know, especially from the venture capital funding level, you know, you have three funds that are represented here that are approximately focused, right, pretty much solely autonomously focused. And one of the comments that was, you know, came up regularly, during our discussion with limited partners was ophthalmologists too narrow, you know, when you’re going to do what you’re going to, you’re going to do a fun, just on the eye, that’s way too narrow, and they’re in there couldn’t be something more, you know, untrue. As an investment target, when you look at ophthalmology, there are so many different opportunities to provide improved and disruptive care in ophthalmology, because there are so many distinct disease states, so many therapeutic challenges that have to be solved. And if you just look at the amount of dollars, you know, contributed it, that these larger VC opportunities, and then add all of the, you know, earlier stage investment, there are so many so many unmet needs in the treatment of this tiny little organ in our body. That that it I think all of us would agree that this is so far from narrow, it’s the opposite. It’s hard to differentiate sometimes and distinguish all the opportunities when he says just about one disease, macular degeneration, and you think about how many different opportunities and different ways there are to try and address both wet and dry eye macular degeneration and all the drug therapies and all the potential targets. It’s incredible how much opportunity there is funding in ophthalmology.

Ehsan Sadri: See, I will make one more comment. I’ll be remissed from us. A couple of colleagues on a slide surface, Cameron, I don’t know if you know, Hussein, he is a CEO, serial entrepreneur. We were also, you know, investors, that’s mostly a dry eye, anti-inflammatory play. And, you know, I agree with Rob, I mean, it’s a big, it’s a huge, but small sort of a market. In other words, it’s a big I think it’s north of $50 billion annual. And I think that’s it’s just growing, and then there’s tremendous amount of appetite for the ophthalmic space. And I think, personally, and you know, I think you guys would agree, it’s the Renaissance of Ophthalmology right now. If you think about the last, you know, five years and what’s going to be on the horizon. It’s tremendous. It’s very exciting, very exciting.

Craig Simak: Well, to that point, I mean, the public seems to have it continue to have an appetite as well. Right? For ophthalmology technologies.

Rob Rothman: Very, I think they I think it’s the same concept that we brought up before, which is that, you know, the population is getting older, eye disease is becoming more prevalent. Incidence of diseases is increasing. As a glaucoma specialist. You know, the general commentary is that only half the people who have glaucoma are currently diagnosed and treated. So you think about how much more you know, healthcare money is going to need to be spent on some of these diseases that I think this search for better outcomes, improved technology, things that improve quality of life for patients overall is going to be is going to be growing, not shrinking. And if you look at the diversity of the companies that have, you know, entered the public market, it is again, it’s a very diverse space. And I think that we you know, all recognize the fact that there are many, many more companies that will be entering the public space over the next year this will continue because there’s as Ehsan said, this is a renaissance time there is so much unbelievable technological and scientific development going on in ophthalmology right now that this is going to be a trend that grows.

Firas Rahhal: To Rob’s point. Again, there’s such a diversity of opportunity, just on this slide alone. You see Iveric and there’s this entire burgeoning area of dry-AMD treatments. And these companies are going public earlier and earlier, you know, because of the appetite for the markets for these kinds of investments, you know, decades ago, you wouldn’t see companies going as early as they do. Now you’re having Biotherapeutics going public in the preclinical stages, which was, I think, unthinkable 20 years ago. And then on the other hand, even within macular degeneration, you have another slide, another section on here, Outlook therapeutics, a completely different animal than all the others approaching it, they’re just figuring out a way to properly ophthalmicly package the vast, you know, an old standby a stalwart in the treatment of retinal diseases for 16 years. And so-, almost the opposite, then what an Iveric is doing, Iveric is bringing this brand new, incredible science to a disease that’s untreatable, and Outlook’s bringing a very useful tool to a disease that’s being treated now with a drug quite similar to what they’re bringing. But again, big appetite for this stuff, because the markets huge. And to add to what both guys said earlier, Craig, I think people ought to understand and I know you do, the public. And this has been shown repeatedly and with a high magnitude, the American public values vision and site preservation at one of the highest levels, and polls keep showing this, and the CMS studies this and they decide how they’re going to allocate money within CMS. And I think the private funding environments sort of reflective of that the public wants this.

Rob Rothman: So I think the fact that these companies have been given the proper guidance that, hey, there’s enough appetite in the public market for positive phase two data, not only from public offerings, but even significant strategic involvement at the post phase two level, that’s pretty unusual. And I think it’s a telling sign for what ophthalmic innovators can expect going forward, which is that if they can get themselves to a point where they have really solid phase two data, that there’s a real opportunity for them, at that point, to create value for investors and bring their product to market. And I think that’s the most encouraging thing. And there are a couple of phase two exits on this slide. But I think that’s the goal. I think, as an investor that we look forward, you know, how likely is the funding that we’re going to provide for these companies is going to get them to a phase two, you know, data readout, because that’s really where we can see true value creation for investors. And I think that this slide sort of proves that.

Ehsan Sadri: For me, what I would sort of think about when I see this slide is, you’re going to see some inhibition from the largest traditional sort of strategic, so acquire some of the earlier phase two driven companies. So the company has to capitalize either private investors will go public, and that was not the case 10 years ago. In other words, you know, those, the strategics had a big appetite for purchase. And that was a traditional route is very rare, to Rob’s point to see a company early, trying to exit and get good capital. But you know, that’s been a really nice way to sort of raise money and avoid the trap of not being able to get picked up by strategic just because there’s fewer strategics out there post mergers.

Craig Simak: So that’s a perfect segue into M&A activity.

Rob Rothman: Well, again, you’re looking at, you know, you’re looking at these high value acquisitions, you know, these, you know, the price points for some of these, you know, and again, so, you know, going back to the previous slide, like when, when we discuss the fact that there’s an opportunity for inflection at a face to exit, if I was a risk taking strategic partner, you start to look at the cost that it takes for a company to acquire a phase three or a clinical product that’s already got revenue. So you look at Ivantis at $475 million, there’s possibility that Alcon have the opportunity to look at that product when it was $150 million-$175 million at an earlier stage. And I think that with these companies have, as Ehsan’s point, lots of cash, and the availability to make acquisitions later. And, you know, we have to try and understand what their risk appetite is going forward, because it matters. When we consider how to fund these companies. Not every small company wants to become a big company, some of them actually want to be acquired, right? Not every company wants to build a Salesforce and start selling products, some of them would like to be, you know, managed by somebody bigger and stronger. So when you look at some of these numbers, you think about that, at least the disclosed prices, you’re not going to see a lot of $6 billion mergers, you know, it doesn’t happen that often, you know, in ophthalmology unless it’s a huge, you know, sort of a huge, you know, opportunity, you know, from a market perspective, most of these companies, I think, again, at the strategic level, you know, have a desire and have proven that they have the need to have both an early mid and late stage life cycle when it comes to product development. And what I hope we’re going to see is that they start to look at companies and acquisitions that meet all of those demands, that they’re not just going to be doing the post market, half billion-dollar acquisitions, that they’ll make some earlier investments, you know, look at companies at an earlier stage that are promising that meet their specific internal and undisclosed mandates for, you know, market segments that they’re looking to attack. And that will start to see that activity happening. And I think it will, just because there is such a huge availability of it’s a target rich environment for them right now. Right, there are so many high-quality targets out there, that we can’t imagine that they’re just going to not start to take things early or acquire them earlier or bring them in house or let them be developed externally in a partnership. But it’s great to see that they’ve engaged in these later stage deals, I think that will continue to happen. But I think that you’re going to see a lot of funding happening at an earlier stage as well.

Craig Simak: As far as acquisitions.

Ehsan Sadri: I’ll make a comment here too, I think Rob’s point is really good. But I would also say that, you know, the strategics now are sort of buying the revenue. If you look at a major decision announced just last week from Rayner that’s a really good partnership because you know, Rayner is traditionally in the OR, if you look at their iOl platforms is mostly some in the US activity now, there have done direct and also indirect distributorships in the US, but Omidria that you know that’s a big price tag. And let’s face it, if Omidria didn’t have any reoccurring revenue, and proper CMS regulatory pathways, that number will be much lower. So to me, if you’re listening to this, and you’re sort of in a startup world, the sooner you can sort of help commercialize and create revenue, the higher your valuations gonna be of your company. And I think that’s the take home message here.

Craig Simak: Great. So let’s scroll through some of the, we’ll start getting into regulatory approvals. So this year, not so much on the 510K side, there was Omni surgical systems was the only thing I think that really stood out because it granted specific labeling, for IOP reduction, whereas previously, it was just a tool.

Ehsan Sadri: The thing I would say, there’s you know, if you if you compare this slide, the one previous, you know, the revenue stream comes from basically getting progress approved. So the 510K model or strategy is actually a pretty rapid strategy. In other words, you know, a lot to do with how quickly you can come to market and create revenue. So I think the salient point here for this slide is, there’s going to be other companies that follow the, you know, outside Sight sciences pathway in this space. You know, I know a few. And I think that that’s and the reason there is because the 510K pathway is fast. But also if you’re a company and you’re going to use 510K, I think it’d be really good to already have reimbursement in place. Because if you have reimbursement in place, then you’re going to be very attractive. So not only do you have a product in the marketplace quickly, but you also have reimbursement for the doctor to actually get paid. And then you’re gonna have revenue stream almost quickly and very quickly. And so this strategics will look at you. And as you saw earlier, that’s where your value add is, and that’s how you get those big pops.

Rob Rothman: Right. And that’s also again, from the investment side, Ehsan, you’re correct, you know, having a predicate device where you can 510K off of that, you know, speeds up the development. And if you think about the way ophthalmic development, and probably this exists outside the world of though I don’t care about anything but ophthalmology. But ultimately, you know, there’s this stepwise sort of logical development process that occurs where things build on each other, right? There’s clinical improvements, there’s technological improvements, 510K is designed to allow somebody else’s prior safety data to serve, you know, for your benefit, because you’re saying, Hey, we’re not substantially different with regard to what we do. And this is why we believe that pathway is viable. And I think the FDA ability to process that has been unbelievably helpful, right? In this new collaborative approach. I think the FDA is taken towards trying to make sure things get to market in an appropriate time. And I think that’s been helpful. So Sight Sciences was certainly the beneficiary of that. And, you know, ultimately, the difficulty for investors is trying to not think about always, what’s the next incremental thing, but what’s going to be three steps down the road. And as it makes sense, and when you’re right for entrepreneurs or startups who may be listening to this, it’s important to understand you know, the people that came before you determine whether or not what you’re doing is going to be acceptable and fit into the model of, you know, incremental growth over time. Except for something let’s say like dry end where we’ve never really had any therapy, every almost everything that’s going to build off somebody else, right? Somebody is the first gene therapy that everybody else is going to get the benefit of gene therapy, someone’s going to tackle the super coronal space and then everybody will get the benefit of that. And there’s only one of those but many that can follow.

Craig Simak: NDA/VLA Approval. So this I actually had to get from Wiley, anything here, you guys think about.

Firas Rahhal: Here the, for me, this was just mentioned, actually, there’s a couple of things in the posterior segment here that are important. We’ve been waiting for some of this to start coming online, you have here the Xipere, which is just a steroid. But the point with Clearside, and what they’ve done is, and Rob just alluded to this, incidentally, they’re opening up this avenue to deliver drugs and products into the super coral space in the office, it remains to be seen what’s going to be the long term or even short-term role for that, because all the therapies that are being considered for it are still in flux. Also, it’s now something that’s being used to deliver gene therapy, which makes a lot of sense. But this has generally historically been a space we tend to avoid as retina surgeons, we don’t necessarily want to be there. But if you can be there in a controlled manner, there’s promise for simplifying what will be coming not so much the steroid, I think that’s wonderful. But we already deliver lots of steroids in lots of ways. But this anatomic technique is looking like it may end up having great relevance in the more complex delivery of regenerative medicine and so forth. And the other thing that stands out for me, and I’m not going to try to pronounce the name, yet I continue to call it the PDS or Port Delivery System. Roche has been, you know, working on this for many years, we, I know the history of who developed it, and so forth. But I think the point to me about Port Delivery System is this is the first of probably many drug delivery conceptualizations. This was one of the first conceptualizations from many years ago, long before you know, Roche was developing it, which is, you know, essentially a depot kind of concept for Intravitreal Therapy, we’ve all wanted such a thing. I think how much market penetration there will be for this is, I don’t think it’s anyone’s guess I think it’ll be relatively low. It’s a great device, and it adds to the armamentarium. But you know, this is, this has become a fairly consistent office space therapy that we do a lot of, and we’ve done 10s of millions of injections around the world. And although patients might be frustrated by that, the older people who are in this population are a little bit reluctant to go to the bar and their doctors are reluctant to take them to the bar. I will use this technique. But I think that the percentage of the market that will go to this, I think will probably be small, but significant and very useful for those people that that do go for it.

Ehsan Sadri: I want to comment here. A couple of things from my standpoint is that it’s pretty intriguing. You know, you’ve got to dry eye and presbyopia so presbyopia, as you all know, is probably, you know, arguably next to myopia degeneration, probably the largest unmet need in the world in the US is about 120 million Americans that suffer from presbyopia. So you’ll see some sort of, you know, rendition of pilocarpine or combo pilocarpine sort of therapies, AbbVie is just approved and now in the marketplace actually had a patient yesterday who somehow got their hands on a bottle from CVS and brought and showed it to him which is kind of cool. So for those people listening don’t know what presbyopia is basically your cheaters that’s like me, I’m getting old, and I can’t see, and everyone comments on my font on my iPhone. So I’m actually really excited about this personally, just because I think there’s you know, even though there’s about I think now eight competitors in this space, that the market is huge. And I think it’ll change the landscape for us cataract refractive surgeons, because the reality is people are going to come in, and not everyone’s going to be a candidate for this type of technology, but it was just kind of create that awareness. And that discussion points for people to come in. So that’s the first one I’m really excited about. Obviously, the spray, you know, and you know, you’ve got Oysterpoint, and there’s a lot of data there. We can talk a lot about that. But that’s kind of another intriguing dry eye therapies that hit the market. So patients have choices, and that’s really exciting. I think there’s a lot more to come, you know, that’s coming behind that back, you know, and I think the reality of it is that we were talking about earlier, Ophthalmology is going through a renaissance right now. And I think there’s a tremendous amount of capital internationally too. So you know, companies like all races based in Israel That’s another competitor that’s probably gonna come out in the marketplace. And I think there’s plenty of room for everybody. I think it’s that’s what’s exciting about this.

Rob Rothman: I have a question for you actually, Firas, I think it’s important to discuss here too, because I think, at least for the investment community, it’s critical to understand this. The FDA has generally made it clear that they’re less fond of approving products that offer patient convenience. Right, they really don’t want to fund convenience, or they don’t want to approve convenience. So does this product or in your opinion, is this product going to provide better outcome for patients? Obviously, the FDA agrees that it will. And do you think that there’s an important that it’s important to consider commentary for the FDA, when you’re an earlier, let’s say, startup company regarding their attitude towards what they approve, and what they don’t want to improve going forward? Because this is one of those whereas a glaucoma person, I’m like, wow, it’s great, you can implant something and only inject or fill it, let’s say you have a surgical procedure and maybe a relatively mild surgical procedure. And then maybe people only need two, you know, applications of drugs over the course of a year rather than an injection every, let’s say, six or seven weeks. Is that really something that we’re going to continue to see coming through, in your opinion down the road? Or are we going to start to see the FDA push back a little bit and saying, Well, we don’t necessarily want to see you inject less frequently, you want to see better outcomes?

Firas Rahhal: It’s a great question. It’s been discussed a lot and out of interest I asked Dr. Chambers this on a podium not that long ago? And the answer was, we need to see better outcomes, at least, you know, party line type answer. But there’s some subtlety and nuance there. So the patient convenience factor, I think, will continue from what I’m hearing to not be enough to your point. But in the real world. And this is where the FDA has to kind of have an open mind of how to measure what are real world outcomes versus clinical trial outcomes. If you compare a convenient treatments, so to speak, to monthly anti-VEGF therapy, then yeah, it’s a high bar, where this will this product and other drug delivery products will improve outcomes and not just enhance a quality of life or convenience is that people really don’t get monthly anti-VEGF therapy in the real world that ends up becoming a very small minority of patients. So if you can provide two injections a year, let’s say, and get that person a year of continuous therapy, the equivalent of 12 monthly injections in a really high-level clinical trial that might be Look, maybe looked at as non-inferior. But in the real world, it’s clearly superior, because we have all these shortfalls in the monthly injection regimen. And everyone talks about this, probably less than 10% of people actually get that kind of therapy for 1,000,001 reasons that are outside the scope of this discussion. But if you use real world competitors, I think these at least for wet-AMD, and diabetic macular edema, anti-VEGF therapy, these convenience, products being drug delivery, are actually going to result in better real-world outcomes for the overwhelming majority of patients.

Rob Rothman: Yeah, I think so. I agree. I think since BMO is actually sort of paved the way a little bit for how we’re going to be looking at or evaluating opportunities in drug delivery space. Because it really is going to be required that there’s some benefit and whether you have to discuss that with the FDA in advance of the clinical trial and how you assess improved outcome. I think it’s an interesting time for drug delivery based on CMOS approval.

Firas Rahhal: The agency will, as you just implied, I think we’ll have to figure out ways to evaluate real life outcomes if Europe control group, and the clinical trial is monthly, anti -VEGF and it should be that’s what’s approved. And that only represents somewhere under 10% of patients in real world, even in the US, then you have to find a way to find the comparative group that looks a lot more like the real world. And then you can see if these products are not only showing convenience for all parties, but also improved efficacy, and that’s still being determined, I think, at the agency level or as a country, we have to figure that out.

Ehsan Sadri: Let’s face it, the US is much slower, and much more costly than other parts of the world when it comes when we go to these European meetings. I always feel like wow, we’re, you know, as clinicians very frustrated because we don’t have all the tools even though we lead in ophthalmic investments and really the knowledge were the pipeline of entry for patients here in the US is cumbersome and it needs to change and it needs to get basically bureaucracies, you know, in my opinion, you know, cut down. And I think this is a good testament to that. And I think kudos to the guys in Verona for doing that. And I’m proud of them.

Rob Rothman: Yeah. And again, just as a final comment, you know, just shout out to our government, right? I mean, we’re so used to bad mouthing everything we could do. But the reality is that, even though the IRIS registry I think was originally created to figure out if they’re gonna overpay or underpass in the long term, you know, how well are we doing with regarding the achievement of certain clinical benchmarks, which was really the purpose, I think of the IRIS registry was to find out if we’re compliant. And I think to the early days of reporting for all of us who were involved in that, you know, having to put down what your visual acuity outcomes were pre cataract, post cataract and all this stuff. You know, I think the motivation for it was maybe misguided, to some degree, but ultimately, it’s provided this just unprecedented set of information. And I believe that Ophthalmology is really the first specialty to have such a robust, you know, data pool for use for many, many good things, not just necessarily figuring out, you know, for being overpaid, or underpaid, but just the determination of quality and, you know, outcomes, and the measurement tools that have been implemented in Iris has really just been unbelievably groundbreaking, you know, for the AAO and for the feds who, who helped propagate this. It’s a real big win for ophthalmology, in general, I think it’s gonna make, you know, again, bringing it back to investment, I think it’s going to make the ability to identify high quality ophthalmic technologies for both investment purposes. And the benefit of patients down the road is going to be fundamentally improved by the utilization of what Verana and IRIS registry are going to bring to the research world. So.

Craig Simak: That’s great. Thank you all for, for sharing your insights on this. You know, in summary, what I wanted to make note of is that, like, you know, we’re also we’re still in a pandemic, right. And yet, it has not stalled innovation at the onset of this, it was like everybody was asking questions, like, we didn’t know how this was going to impact clinical trials immediately, right. And then funding like a lot of VCs that I was talking to were like, they weren’t writing any new checks, initially, you know, until we really got our arms around this. And so it’s reassuring to see that like, it did not stall innovation, you know, we’re back up and running. And I feel optimistic about it going forward, I think things will just continue to get better. I wanted to get your thoughts, any closing statements from each of you?

Firas Rahhal: I think you’re I’ll echo your point there. And maybe just add to it. This the fact that we came through especially the early part of the pandemic, pretty quickly in ophthalmology and ophthalmology innovation and development, I think speaks to both sides on one side of the equation. As we’ve mentioned earlier, the patient and national interest in demand in quality ophthalmic care is high, really high, and that’s a driver. And then on the other side, I’ll give a lot of credit to our colleagues in ophthalmology. The brainpower in the innovation is on that side is also very hot. So when you combine those two things, the great demand from the public and the great minds creating new treatments on the ophthalmology innovation side. It I think that explains how we came through the very shortly the pandemic so well.

Rob Rothman: Yeah, now and I’ll fire off and I think that look, you know, there was maybe again, speaking from the personal perspective of our own portfolio, we saw some companies that were engaged in clinical trials have some minor slowdowns in patient recruitment, which would be expected. But ultimately, nobody got derailed. And I think that, you know, Craig, everybody on this podcast today has interviewed people, on behalf of all is well, we’ve asked that question and I think at the every level of ophthalmology, you’ve seen that there has been very little disruption overall, to ophthalmic development. It’s created a probably a significant increase in the sideline capital and dry powder available for entities to invest in ophthalmology. I think it’s helped sort of push, maybe a little bit more of a sort of faster look at telehealth and some of the technologies to allow the practice of Ophthalmology to occur remotely. Because we’ve seen that this is not going to be the last time, we have a pandemic and we’re aware that we’re going to have episodes in the future where we’re going to have less access to our patients, but the bottom line is ophthalmology has come out of this is stronger than it was before. significant funding, significant public you know market activity in terms of IPOs and mergers. And again as Firas and Ehsan both said there was just a significant push towards better. You know, I care that the public value of this highly, is willing to spend money on it, they don’t pay the doctors, but besides that they fund they’re willing to fund the development of products, and at least at the investment level, understand that, you know, improving eye care and producing better outcomes is critical for the health of our country and the world in general, I think we’ll continue to see that the dollars, you know, sort of prove that going forward.

Ehsan Sadri: Yeah, I would say that, you know, echo Rob and Firas is saying, what we’re really saying all along, in this call on this podcast is, you know, if you’re an entrepreneur out there, you have a great idea. This is the time in ophthalmology, this is the Renaissance time, it doesn’t necessarily mean you gotta get funded, but this is a really kind of a testimony too, you know, an idea, a dream that the entrepreneur had. And with the proper diligence and hard work, and possible lot of failure, you can get investors to invest in your idea and go public, and you see it all the time. And this is probably the only one of the only countries in the world, you can do that. And you know, it’s just so great to be part of this and be with colleagues that are, you know, just tour de force, both clinicians, but also improving the landscape, you know, just been honored to be with you guys today. And just really, we’re very blessed and thankful that to be part of as an ophthalmologist and seeing patients every day and having the resources here in this country to provide the best eye care world class eye care, you know, we see patients from around the world that come to our clinics, and there’s, there’s, this is the reason the core of why they come is because of, you know, the innovation and innovation support that we have in this country. So great things are gonna come in ’22. And I look forward to doing this again with you guys next year. And I wish you guys on the families, and everybody have a wonderful think, Craig, thank you for hosting this. I know, it’s a lot of work. I know you’re working really hard down in Florida right now. It’s tough. You’re doing well, we love your brother, we love you.

Rob Rothman: And Craig, just one file. I mean, you know, we are here just for you, I guess, you know, we appreciate the opportunity to do this. I think that the four of us on this podcast, maybe equal 1/3 of Emmett Cunningham brain, like maybe that’s correct, right. Like maybe Emmett has really been the template for this for many, many years has been the faces many, you know, for many, many years, and obviously, you know, special thanks to him for, you know, recruiting all of us to get involved over the years and laying the foundation for this. But, you know, I think having a Year in Review and allowing three physicians who are also investors have the opportunity to comment on this stuff is great. And I certainly appreciate always speaking to Ehsan and Firas, and I think that it’s great, they have the perspectives of three different clinical specialties. But three very similar venture capital funds that are all focused on improving ophthalmology for patients in the United States and across the world. It is a great perspective for this. And it’s a privilege to have been a part of it. And thank you for the opportunity to and for including me.

Craig Simak: Yeah, and you know, the feeling’s mutual, you know, I couldn’t continue to push forward without you guys. And some, hopefully next year, we’ll have some of our own data to use for the Year in Review, you know, we do still have the EyeDeal Source. In development, it’s about 80% complete, so we’ll be releasing a lot of information on startups, and their stage of development, we’re going to be tracking that. And then we have a fairly extensive list of active investors in the space as well. So hopefully, we’ll be able to use this product as a means to help facilitate, you know, even more investment and connections. So stay tuned for that. And hopefully for a live OIS in the spring of 2022 as well. So, gentlemen, it’s been a pleasure, Happy Holidays to the three of you. And I’ll leave it to the three of you going forward to be the podcast hosts, I’ll stay behind the scenes going forward. But this was fun to do this with the three of you today. So again, thank you, and I hope you have a wonderful end of year holidays and a happy new year!