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Glaucoma

Patients with adherence problems, those requiring preservative-free treatment good candidates for bimatoprost implant

Posted on November 1, 2020

In a supplement published in Cataract & Refractive Surgery Today and Glaucoma Today, moderators Preeya K. Gupta, MD and Nathan Radcliffe, MD, and a panel of ophthalmologists discussed which patients with glaucoma are the best candidates for treatment with Durysta, a sustained-release biodegradable implant of 10 mcg bimatoprost.

Good candidates include patients who need to have intraocular pressure (IOP) lowered, said Dr Radcliffe. Inder Paul Singh, MD, The Eye Centers of Racine and Kenosha, Wisconsin, agreed, adding that treatment with Durysta is an option to lower IOP when working on a future treatment plan.

Jim Katz, MD, Director of Golf Laser Vision and a partner at The Midwest Center for Sight, Chicago, also utilizes the bimatoprost implant as a bridge when deciding on future treatment.

“For patients on multiple medications, if I need to stop those treatments for whatever reason, I can administer Durysta, before deciding what to do next,” he said.

Dr Singh believes that the bimatoprost implant is useful in patients who have difficulty with eye drops, whether that is because of an inability to apply drops, poor adherence, or cost restrictions. When a patient is noncompliant with drops, the doctor must first address the issue with the patient, and when possible, offer an alternative treatment option.

“It used to be that my only option other than topical drops was selective laser trabeculoplasty,” said Dr Radcliffe. “Now when I have a patient who needs IOP lowering and either does not want or is not a good candidate for topical drops, I can offer them SLT or Durysta (bimatoprost implant). This is also a good option for patients who have previously had SLT.”

Patients looking for alternatives to multiple drops will benefit from the bimatoprost implant, as well said Ehsan Sadri, MD, Visionary Eye Institute, Newport Beach, California.

“You get the benefit of knowing that the therapeutic drug is being directly delivered to the diseased tissue for consistent IOP control for several months,” he said.

Other considerations noted in the panel discussion include:

  • Durysta should not be readministered to an eye that received a prior Durysta administration.
  • Implantation can be performed in an office exam room setting, a minor procedure room, a hospital, or an ASC.
  • Administration should be done under magnification with clear visualization of the anterior chamber.

Reference
Gupta PK, Radcliffe R, Katz J, et al. DURYSTA (bimatoprost implant): A novel approach to extended IOP control. Cataract & Refractive Surgery Today. 2020;Supplement: September/October.

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