A sustained-delivery, biodegradable implant recently approved by the Food and Drug Administration alleviates the burden of multiple daily eye drops for patients with open-angle glaucoma and ocular hypertension. “This is an important development for patients who sometimes forget to take their drops or have trouble getting them in,” says E. Randy Craven, associate professor of ophthalmology at the Johns Hopkins University School of Medicine and chief of Wilmer Eye Institute – Bethesda. 

According to the American Academy of Ophthalmology, more than half of glaucoma patients do not adhere to their prescribed treatment plans due to factors that include difficulty in applying eye drops and forgetfulness.

The implant provides sustained delivery of bimatoprost, a drug that has been long used in eye drops for the treatment of glaucoma. Craven, who was instrumental in the research and development of the implant, says that because the delivery system directly targets the tissue it needs to bind to, only a small amount of medication is required as compared to eye drops. “If you’re putting in a drop every day for a year, that’s a lot of medicine. But the implant contains the equivalent of what’s in one eye drop,” he says. The fact that the drug targets specific tissues also means that it limits exposure to other tissues in the eye, which may minimize adverse effects such as irritation that can occur with the use of drops.

In clinical trials, the implant – which represents the first injectable drug for glaucoma – lowered intraocular pressure on average from around 25 for most people to 15 or 16. One of the things that surprised researchers was how long its effects lasted: More than 40 percent of patients did not require any additional treatment for at least a year; and in one out of four people, a single injection lowered the pressure for up to two years. 

“Glaucoma is such a big disease in so many ways for such a small part of the eye. There are so many different things that happen with glaucoma, and no one treatment is perfect, but it’s great to have options to offer patients,” says Craven, who expects to begin implanting the device in the next couple of weeks – making him one of the first do so in the U.S. post investigative status. 

 

A product described in this article was manufactured by Allergan. Dr. Earl Craven is a paid advisor to Allergan. Dr. Craven’s advisory service has been reviewed and approved by the Johns Hopkins University in accordance with its conflict of interest policies.