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Sustained-release bimatoprost IOL implant shows long-term IOP control in glaucoma patients

Ophthalmology 360

Key Takeaways

  1. Most patients maintained >20% IOP reduction for up to 3 years without glaucoma drops.
  2. The implant was safely delivered during routine cataract surgery with no serious device-related events.
  3. IOP reductions were consistent across all dose levels, with all eyes achieving good visual outcomes.

In this first human study, a bimatoprost-releasing intraocular lens (IOL) implant maintained meaningful intraocular pressure reductions for up to 3 years in most patients with mild-to-moderate glaucoma, with the majority remaining drop-free and no serious implant-related safety issues reported.

The single-site study enrolled 24 adults who had previously responded to topical prostaglandin therapy. Participants underwent medication washout before surgery. Patients received a bimatoprost dose of 75 µg, 150 µg, or 300 µg attached to a standard IOL and delivered into the capsular bag during routine phacoemulsification. Interim outcomes were reported through 36 months.

Of the original cohort, 21 patients (87.5%) remained in the study at 3 years. Through 24 months, all participants achieved the primary endpoint of more than a 20% reduction in intraocular pressure from baseline without the use of additional glaucoma drops. At 36 months, 95.2% (20 of 21) continued to meet this target while remaining drop-free.

Across all dose groups, mean IOP reductions ranged from 32.3% to 49.3% over the 3-year follow-up, with no significant differences between treatment arms. All treated eyes achieved a final best-corrected distance visual acuity of 20/30 or better.

No serious adverse events related to the implant were reported. The most common side effects included dry eye (21.7%), transient decreases in vision (13.0%), and subconjunctival hemorrhage (8.7%). All implants remained properly positioned within the capsular bag.

Investigators noted that the device can be delivered using standard cataract surgery techniques without altering procedural steps, aside from attaching the drug pads to the IOL. Further studies with larger populations and comparative data are planned to better assess long-term outcomes.

Reference
Tan NE, Katz G, Robles M, Gupta PK, Kahook MY, Sussman G, Yoo P, Radcliffe NM. Prospective Pilot Study of Sustained Release Bimatoprost Implant with SpyGlass Intraocular Lens: 3-Year Results. Ophthalmol Ther. 2026;doi: 10.1007/s40123-026-01313-4. Epub ahead of print. PMID: 41621045.

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