Biotech is a high risk, high cost, high reward world. It's one that Mag Optics, a London-based startup founded by a Syrian father-son team, has only just embarked on - two years ago.

Mag Optics wants to fix eyes.

It has developed a new kind of lens to treat presbyopia (long sightedness caused by age, a condition about 25 percent of people around the world suffer from), and a novel ‘rod’ implant to treat other problems such as short-sightedness and astigmatism.

Junior surgeon Hakam Ghabra and his ophthalmologist father Marwan set the company up in 2014, after escaping the war enveloping Syria two years earlier.

The elder Ghabra had moved the family back to Damascus in 1998, where he proceeded to set up a chain of eye clinics. These proved successful, particularly during the Iraq war when at one point about two thirds of their patient list was Iraqi, but with the writing clearly on the wall the Ghabras let for London in 2012.

High tech eyewear

Today if you have basic eye problems, such as short or long sight, the options are glasses, contact lenses, reasonably painless laser surgery, or intraocular lens implants (IOL) which can cause scarring.

The redesigned IOL took two years to design, and is made up of two lenses that are attached to the ciliary muscles. These control the curvature of the lens and are the ones the brain uses to unconsciously focus the eye.

“What we’ve come up with is essentially a telescope,” Ghabra said. “People who need this lens... are 45 [years old] so they’re not going to have to take it out.”

The corneal implant is where the Ghabras’ work really begins to push the boundaries.

The idea is to implant rods around the sides of the cornea. These act like metal rods in an umbrella to reshape the eye to change the way the lens focuses, yet leaving the center untouched unlike laser surgery which burns away tissue directly above the eye lens.

“We don’t expect more than four [implants per eye],” Ghabra said.

Human trials
Mag Optics is currently negotiating to start ‘live’ testing - that is placing an implant in a person’s eye - in the UK, Spain, and the Czech Republic at four centers in total, in 2017.

The company however did their first test in Damascus, drawing on patient lists from the family’s still-operational eye hospitals.

“Damascus has become quite [important] to the development of the business,” Ghabra said.

He said heading to Syria wasn’t his preferred option, but they’d been working on cadavers and a VC they pitched the concept to said they needed “to get it into an eye” as fast as possible.

The trial was under the purview of ethics committees from the clinic and the University of Damascus, with the procedure done for free with a “fully consenting” patient.

The patient had to be shortsighted, under 50 years old and accessible. It took six months and about 100 people to find the right patient, a person Ghabra said he couldn’t discuss due to patient confidentiality.

Buying blue eyes

The rods have already found an unexpected market in the Middle East. They can actually change the colour of the eye and be implanted so they don’t change the shape of the eye at all.

Ghabra said there was huge demand in the region for blue and green eyes, fulfilled by everything from coloured contact lenses to lasers that blast the iris to dislodge the pigment (as problematic as it sounds).

He said in the UAE a woman even went so far as to have her own iris removed and replaced with one from a dead donor.

“Clearly there is a need,” he said, noting that a proof of concept for the non-medical use could be ready in 22 months. He’s so far fielded interest from UAE hospitals and Beirut Eye Specialist Hospital director Dr. George Cherfan.

Biotech is a startup-free world in MENA

In MENA only 3 percent of healthcare startups are involved in hardware and none in biotech, according to a report by the Wamda Research Lab and GE.

Digital medicine companies like Altibbi demonstrate the potential, but the barriers are high. Little technical talent and “antiquated legislation” were problems, as was a lack of investors interested in fronting up with the millions, rather than thousands, of dollars early stage biotech companies need.

Then again, biotech is a field that non-specialized investors generally tend to be leery about, given the long lead times to commercialization (see the chart below from Versant Ventures) and the difficulties of getting new products approved.

The eyes have it

Mag Optic’s products are still a good two years away from certification yet have no shortage of competitors.

A year ago Calhoun Vision in the US raised $68 million for an IOL, while in April glaucoma treatment startup Istar Medical raised a $10 million Series B round.

Biotech generally is attracting considerable attention, with venture capital database CB Insights saying last year VC-backed biotech companies raised over $6 billion in 473 deals.

In April this year cancer therapeutics startup Stemcentrx was acquired for $10.2 billion, a sale CB Insights said was the second largest VC-backed deal ever. The third largest deal was also biotech, Astra Zeneca’s $7.3 billion purchase of a controlling stake in Acerta Pharma in 2015.

In for the long haul

Mag Optics is self funded so far, thanks to partnerships with people like the University of Liverpool professor of biomaterial mechanics Ahmed Elsheikh, and biomaterials manufacturer Contomac, but is seeking $5-6 million in seed funding.

“We brought on a former investment banker, as we thought we do the research quite well but we don’t do the other stuff so well,” Ghabra said, Chicago-based Geeta Singh who handles business in the US. “A lot of people have come asking us for more than they are giving us, so we’ve had to be quite vigilant.”

As for when they might be looking at actually making some money, “ask me in eight years time”, Ghabra said.

This article has been edited to remove information about Mag Optics' Syria-based human trials.