Aceclidine

While the large presbyopia space lacks a successful drug launch story, William Blair analysts argued that Vizz holds blockbuster potential given its differentiated efficacy and durability. Lenz Therapeutics has earned the FDA’s go-ahead for its aceclidine eye drop to crack the large presbyopia market, where past efforts by other drug developers have mostly been unsuccessful.The aceclidine 1.44% solution is now cleared under the brand name Vizz to treat adults with presbyopia, a form of farsightedness that’s commonly known as age-related blurry near vision, Lenz said Thursday.While broader commercial supply will not be ready until around November, the company expects to offer samples of the drug as early as October.Despite the outright failure or lackluster performance of past presbyopia drugs, such as AbbVie’s Vuity, analysts at William Blair and Citi argued that Vizz’s best-in-class profile may afford it a better chance at a successful rollout.Lenz has touted aceclidine’s novel mechanism of action as a pupil-selective miotic that predominantly interacts with the iris versus the ciliary muscle. By contracting the iris sphincter muscle, the drug may produce a sub-2mm pupil that extends the depth of focus to improve near vision without disrupting a person’s distance vision.Two phase 3 trials of Vizz, dubbed Clarity 1 and 2, met all primary and secondary near vision improvement endpoints, showing the drug can improve near vision within 30 minutes and last up to 10 hours. The FDA label for Vizz does include a warning about the risk of retinal tear or detachment. But William Blair analysts described the labeling as expected, given that those potential outcomes are a known risk for all miotics and no cases have been observed specifically with Vizz so far. Therefore, the team suggested that this issue won’t impact adoption.One potential surprise, however, is that while Lenz has labeled Vizz a once-daily solution, the drug is actually recommended to be given in two drops per eye two minutes apart. Nevertheless, the William Blair team again argued that this is a minor distinction for Vizz’s commercial profile.Presbyopia represents a “large, untapped” market, William Blair noted. AbbVie’s Vuity became the first FDA-approved eye drop to treat the condition in 2021. But as of 2025's second quarter, the drug didn’t have a separate line in AbbVie’s revenue report.Vuity has some safety issues, such as blurred vision and headache, which, although mild for most people, can be disruptive to the point of affecting patient adherence. Further, even after an additional FDA nod for a twice-daily dosing option, the drug’s effect can last just up to nine hours, shorter than Vizz’s 10-hour maximum through once-daily administration. “[W]e believe Vizz’s differentiated efficacy and durability positions it well for success,” the William Blair team wrote in a Thursday note, adding that it believes the drug holds blockbuster sales potential.“The FDA approval of Vizz is a defining moment for Lenz and represents a transformative improvement in the available treatment options for the 128 million adults living with blurry near vision in the United States,” Lenz CEO Eef Schimmelpennink said in a statement Thursday.To prepare for Vizz’s commercialization, Lenz has hired an 88-member sales force, the company disclosed in its second-quarter report Wednesday.