Sight Sciences wins Aetna coverage for OMNI and SION glaucoma systems

Aetna has recognised both implant-free MIGS devices as medically necessary for mild-to-moderate open-angle glaucoma, completing major US payer coverage for Sight

The Biotech Times Editorial Team By The Biotech Times Editorial Team
A curved-tip surgical instrument and surgical forceps rest on a blue sterile drape in a brightly lit medical room, with a surgical microscope in the background and a window to the right.

Sight Sciences has secured a significant commercial milestone after Aetna updated its Glaucoma Surgery Policy to recognise the OMNI Surgical System and SION Surgical Instrument as medically necessary for mild-to-moderate open-angle glaucoma. The policy, which applies to Aetna's commercial plans and covers approximately 25 million lives, took effect retroactively from 14 July 2026.

The Menlo Park-based company said the decision means broad payer access is now in place for canaloplasty and goniotomy procedures enabled by its two devices across all major national payers in the United States, a threshold the company described as a meaningful marker of commercial maturity.

The coverage decision

Aetna's revised policy covers ab interno canaloplasty, for which OMNI is cited as an example, and adult goniotomy, for which SION is cited. Coverage applies when specified clinical criteria are met. Both devices are implant-free, which distinguishes them from older stent-based MIGS approaches and was a point of emphasis in Aetna's clinical review process.

Paul Badawi, co-founder and chief executive of Sight Sciences, said: "With this coverage milestone, broad payer access has been established for canaloplasty and goniotomy enabled by the OMNI Surgical System and SION Surgical Instrument across all major national payers."

The OMNI system is CE Marked in Europe and cleared in the United States for reducing intraocular pressure in adult patients with primary open-angle glaucoma. The SION instrument is a bladeless, manually operated device used to excise trabecular meshwork. Sight Sciences noted that surgeon advocacy, key opinion leader engagement, and involvement from ophthalmological societies were instrumental in advancing the coverage decision.

Market context and competitive landscape

Payer recognition is a critical bottleneck in the MIGS segment, where clinical adoption has often run ahead of reimbursement certainty. Glaucoma affects an estimated 80 million people globally and is the leading cause of irreversible blindness worldwide, making it one of the larger addressable markets in ophthalmic surgery. The shift toward minimally invasive, implant-free approaches reflects a broader trend in the specialty away from trabeculectomy, the traditional surgical standard, which carries a more complex post-operative management burden.

Several companies compete in the MIGS space, including Alcon, which markets the CyPass Micro-Stent legacy position, and Glaukos, whose iStent portfolio has held Category I CPT codes for a number of years. Sight Sciences' argument for its implant-free positioning is that it avoids long-term device-related complications, and Aetna's positive coverage review may lend clinical credibility to that claim. Investors will now focus on whether the Aetna decision accelerates volume at existing accounts and opens new surgeon relationships, as well as how the company translates payer coverage into revenue growth over the remainder of 2026.

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