Revenio’s Icare launched slit lamp tonometer

Translation: Original comment published in Finnish on 9/6/2024 at 7:06 am EEST.

Revenio's subsidiary Icare yesterday announced the launch of the iCare ST500 packing the essential features of iCare rebound tonometry technology into a modern slit lamp-based design. It is our understanding that the technology and performance of the device is roughly equivalent to the IC200 tonometer, but the design and intended use are significantly different. We believe that the iCare ST500 will provide a new channel to increase market share in tonometers and expand the iCare product portfolio in line with the strategy. We are positive about the product launch but will not make any forecast changes based on the launch, at least for the time being. 

iCare ST500 slit lamp tonometer

The iCare ST500 slit lamp tonometer is a product designed for the eye care practitioner and can be connected to existing slit lamps (from other manufacturers). Based on clinical studies, iCare ST500 has a high correlation of IOP measurements with the current gold standard applanation tonometry device (GAT). iCare ST500 can therefore provide comparable results to the current standard device, and the data showed lower variability between repeated results compared to GAT. This is how Revenio aims to gain the trust of practitioners.

The real benefits are the key advantages of rebound technology familiar from other iCare tonometers: 1) no need for topical anesthesia nor fluorescent dye, 2) no need for long collateral procedures like calibration, and 3) no need for disinfection nor sterilization. These are the differentiating factors from the traditional Goldmann applanation method. However, as we understand it, anesthesia may not be completely avoided, depending on what other examinations the ophthalmologist is performing. In this case, the direct benefits may be less, but we believe they are still significant.

With the ST500, iCare also introduces the new SmartCradle: a key element that allows users to take advantage of a rechargeable lithium battery. The cradle also allows easy connectivity and digitalization of IOP measurements and enables the application of Revenio data tools. iCare ST500 also includes a Quick Measure feature. The technological basis and features of the device are presumably those of the iCare IC200 tonometer.

Goldmann still the leading method in slit lamps

Although Revenio has achieved a leading market position in tonometry with its rebound technology due to its distinct advantages, the Goldmann applanation method, developed in the 1950s, is still the standard in slit lamps for measuring intraocular pressure. As a result, this method is still used in many clinics in a variety of situations, even when an iCare tonometer is also available. The new iCare ST500 can be combined with virtually any slit lamp to replace the outdated method, giving Revenio the opportunity to further erode Goldmann's market position. We believe the benefits of rebound technology are obvious and so the future trend is clear, but the speed of change is again a significant question mark.

The iCare ST500 is ready for sale in Europe, i.e. it has MDR approval, but the FDA approval required for the US market is still pending. However, we understand that clinical trials have already been conducted for the FDA study as well, so a US marketing authorization may possibly be expected by the end of the year. Once the US marketing authorization is granted, we will have a clearer picture of the market reception. In terms of pricing, it appears that the device is provisionally priced below the iCare IC200 tonometer.

Promising product, but we are not changing our forecast for the time being

Our initial reaction is that the new product will accelerate the growth of iCare's market share in the tonometer market. We believe that the iCare ST500 essentially expands Revenio's product portfolio in line with the company's strategy and provides a new channel into the tonometer market where it replaces inferior technology. However, it is easier to assess the impact based on market reception and concrete sales figures, and we have already assumed in our forecasts that the growth of tonometers will continue at a good level in the coming years. We are therefore not making any changes to our forecasts as a result of this product launch. The positive aspect of the product positioning is that it represents a new segment for iCare. In this way, the device does not cannibalize sales of other tonometers but opens up a new avenue and expands iCare's product portfolio.