Less than four years after returning to Bausch + Lomb to lead the eye health company following its split from Bausch Health, Brent Saunders is hitting the exit once again.
Saunders is stepping down as Bausch + Lomb’s CEO through mutual agreement with the company’s board, Bausch announced Monday.
Bausch + Lomb’s chairman since August, Thomas Appio, who’s also been serving as CEO of the eye-care specialist’s parent company—Bausch Health—since 2022, has stepped in as interim CEO.
Saunders’ departure comes as a surprise, as Bausch + Lomb had laid out some bullish targets during an investor event in late 2025, Evercore ISI analysts said in an Oct. 12 note. As Appio is now assuming leadership temporarily, the analysts suspected that the transition was a bit of a surprise to the company as well.
Saunders returned to Bausch + Lomb in early 2023, less than a year after the company completed its initial public offering and separation from Bausch Health, which has retained a controlling stake. Saunders previously led the company from 2010 to 2013 until its acquisition by Valeant, which later became Bausch Health. Saunders went on to serve as CEO of Allergan until its $63 billion buyout by AbbVie in 2020.
“When I returned to Bausch + Lomb, I believed this company had tremendous potential,” Saunders said in a statement. “Today, it is stronger, more focused and better positioned for the future, with a clearer strategy, a more robust pipeline and significant opportunities ahead.”
During an interview with PharmExec last year, Saunders highlighted three priorities for his return, including beefing up Bausch + Lomb’s sales and marketing prowess, stabilizing its global manufacturing network and revamping R&D.
The company suffered several setbacks last year, including a failed sale to private equity and a recall of certain implantable intraocular lenses. Then this July, Bausch + Lomb abandoned an alpha-2B agonist, dubbed BL1107, following a failed phase 2 glaucoma trial.
Also calling the CEO transition unexpected in an Oct. 12 note to clients, Leerink Partners analyst Daniel Clark said he remains “confident in the fundamental trajectory of the business.”
Alongside the leadership announcement, Bausch + Lomb and Bausch Health said they currently expect to raise full-year 2026 adjusted EBITDA guidance based on preliminary calculations of third-quarter results.
Bausch + Lomb should continue to benefit from growth in dry eye disease, led by Miebo, Clark said, while calling the company’s pipeline assets “intriguing.”
The Canadian company recently advanced a combination of its eye drugs Xiidra and Miebo into phase 3 despite missing the primary endpoint of a phase 2 trial.
The company is also developing a potential first-in-class topical drug targeting transient receptor potential vanilloid 1 (TPRV1). Called BL1332, the investigational drug is being evaluated as a potential treatment for multiple forms of ocular surface pain. An ongoing phase 2 in patients experiencing pain following photorefractive keratectomy surgery is expected to read out soon.
“Miebo’s speed of relief is drawing untreated dry eye patients into the funnel, and we expect this, along with Xiidra’s stabilizing gross-to-net, to keep the pharma franchise growing well past 2026,” Clark wrote in a September note when he initiated coverage of Bausch + Lomb.