Travoprost intracameral implant reduces IOP, need for IOP-lowering medication for up to 3 years in patients with glaucoma
Steven Sarkisian, MD, founder and CEO of Oklahoma Eye Surgeons, spoke with Ophthalmology 360 at the American Society of Cataract and Refractive Surgery Annual Meeting about a study that showed the IOP lowering effects of iDose TR at up to 3 years.
Steven Sarkisian, MD:
Here at ASCRS 2025 in downtown LA, [I] have an opportunity to present about an exciting new technology, the travoprost sustained-release glaucoma implant, the iDose® TR, and had the honor of being in phase 2 and phase 3 of the clinical trial. The data I’m presenting here is specifically the phase 3 trial data talking about the efficacy out to 36 months with the iDose® TR. iDose® TR is a microscopic implant made of titanium that slowly releases travoprost. It’s a travoprost oil that’s inside the implant. It gets implanted into the anterior chamber and gets anchored into the angle.
I implant them superiorly so that the eyelid covers them, and the goal is to have people become less dependent on medications. But I think we’re going to see, and the data bears out, we’re going to see so much more because, if you think about it, what is one of the major problems affecting people today with or without glaucoma is ocular surface disease and dry eye. Eye drops have so many toxins in them because the dose of medicine has to be so high for it to get through the extraocular tissues to finally get inside the eye in order to change the outflow inside the eye. Because glaucoma is an outflow disease, and it makes sense that if you have the thing that’s modulating outflow, improving outflow to be inside the eye, right next to the tissue it’s trying to change instead of having to artificially go through all of these things with a bunch of chemicals and a vehicle with all these preservatives, it makes a big difference.
Interestingly too, compliance is a big issue so if you have a sustained-release implant it makes for perfect compliance because you take it out of the patient’s hand. But it’s not even just compliance. You take a drop, you take a drop every single day, even with perfect compliance, if you have a 24/7 sustained release, you have a very steady state. That’s really what the exciting thing is, that we showed that 81% of the patients were medication free at a year, and we basically were able to get people on pressure drop at 1 year, somewhere between 6.2 and 7.1. In the paper I presented, at 3 years it was 6.2. At 12 months, it was 6.5 pressure lowering drop, but also with the vast majority of the patients being on the same or fewer medications as well. But 81% being on no medicines, which is a big deal.
In addition, and it wasn’t pointed out in this study but if you look at a subset of the group, the iDose is actually superior to being on an eye drop in that the pressure is lower with the iDose® TR because we just took out a subset of the patients that were just on travoprost in the study and we looked at them and what their pressure was at the 3-month washout where the patients that were just on travoprost or the ones that were on the iDose® TR, and the pressure was 1 to 3 mm lower in the iDose® TR group. It’s not just equivalent or an eye drop replacement but it’s superior because it doesn’t affect the ocular surface, there was no endothelial cell loss. It’s perfect compliance and it actually is more effective from an IOP standpoint than topical eyedrops. Thank you, thank you for your time and for allowing me the opportunity to visit with you today about what I got to present at ASCRS.
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