Eyeworld

I TECHNOLOGY & INNOVATION N FOCUS 48 | EYEWORLD | MAY 2019 "From the standpoint of the glaucoma space, that's where there is the most excite- ment. There are a lot of different opportunities there," Dr. Swan said. "The last 5 to 10 years have been dominated by MIGS," he added later, "but I think drug delivery will be the next tale to tell, and it will cross over into many other areas of ophthalmology. We will have more op- tions to take compliance out of patients' hands and improve delivery without ocular surface side effects." Overall, Dr. Donnenfeld called drug delivery the "most exciting, disruptive area in ophthalmology today." "Drops as we know them will cease to exist over the next couple of years as new drug deliv- ery systems change the way we deliver medica- tions in a more effective and compliant manner for patients," he said. Dr. Matossian expressed a similar sentiment and added that the minimization of drops dove- tails with the premium cataract surgery experi- ence that many patients have come to expect. "Patients' expectation is that their cataract surgery is going to have a positive impact on their life, and decreasing the drop burden will reinforce that positive patient journey," she said. FDA approval of this product, Dr. Don- nenfeld said, is a "major step in the right direc- tion for drug delivery overall, and hopefully, all of our medications will be prepared like this in the near future." Dr. Matossian said Dexycu injection should be comfortable to cataract surgeons because they are in the same space, injecting the ste- roid above the IOL under the iris. She said she will eventually use Dexycu with intracameral antibiotics as well, which will leave her cataract patients with just one NSAID drop a day. Injection of intracameral antibiotics and compounded medications is a relatively com- mon practice after cataract surgery. Dr. Swan said he injects compounded dexamethasone, moxifloxacin, and ketorolac at the conclusion of cataract surgery. "I think there is an undeniable decrease of endophthalmitis with intracameral antibiotics," Dr. Swan said. On the glaucoma front, Allergan is working on a bimatoprost sustained release, biodegrad- able, anterior chamber implant, while Glaukos has reported data on iDose, an intraocular im- plant that has provided sustained IOP reduction over at least 12 months. continued from page 47 Dr. Donnenfeld injects Dexycu after cataract surgery. Source: Eric Donnenfeld, MD 1. Compliance 2. Corneal problems (dry eye) 3. Comfort 4. Cost 5. Cosmesis (red eyes)

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