Nikhil Wagle, M.D.

Studies show that up to 80% of glaucoma patients are not using topical medications properly. Poor adherence to topical medications can lead to glaucoma disease progression and vision loss. Given these issues, the FDA has approved several interventional procedures to help stabilize glaucoma. These approved procedures include sustained-release intracameral implants used to treat open-angle glaucoma and ocular hypertension to help patients who are having a difficult time using eye drops.

Durysta (bimatoprost implant) is a prescription medicine to reduce eye pressure in patients with glaucoma. With a quick, easy office procedure, the Durysta implant can be inserted in the front chamber of the eye where it slowly releases the active medicine to help control the intraocular pressure. Placement of the implant in the front chamber of the eye allows for close proximity to the tissues involved in controlling the eye pressure, where it delivers bimatoprost 24/7 for several months. It has been shown to be quite effective in lowering intraocular pressure by at least 33% in two large phase three clinical trials. Durysta was found to control the eye pressure in 66% of patients for at least six months and about 35% of patients for at least a year. As with any medication, some people can experience side effects from Durysta and those will be discussed prior to placement.

iDose TR image size Another FDA approved device, iDose TR, is a tiny implantable device containing the glaucoma medication, travaprost, which is anchored in the scleral wall of the eye. The procedure is done in the operating room through a small incision and takes just minutes to perform. From the FDA studies, over 80% of patients were medication free one year after having the Idose device implanted and many have had successful intraocular pressure control for three years! The added benefit to this technology is that after three years, the device can be removed and replaced with another Idose. As with all interventions, there are side effects and contraindications, but most were found to be mild and transient.

These innovative technologies are especially useful for patients with dexterity issues like Parkinson’s Disease, memory issues such as Alzheimer’s disease or dementia, or those who have an intolerance to eye drops. Moreover, the tolerability of the implants has been shown to be better than using eye drops. Many insurance companies cover the medicine and procedures.

The approval of these implants marks a breakthrough milestone for glaucoma patients and provides a much-needed option for patients challenged with topical drops or needing alternative options. Millions of people are living with glaucoma and new treatment options are essential to help doctors and patients better manage the disease. Eye Surgeons Associates is excited to offer these new and innovative drug delivery systems to the Quad City community.

Bio: Nikhil Wagle, M.D. is board certified with a fellowship in glaucoma. He sees patients in our Rock Island and Bettendorf offices.

The material contained in this article is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health care provider.