Eyeworld

I REVOLUTION IN GUCOMA MEDICATIONS N FOCUS 54 | EYEWORLD | MAY 2020 Contact Al-Aswad: Lama.Al-Aswad@nyulangone.org Williamson: blakewilliamson@weceye.com really need two medications to lower/maintain IOP or will improved compliance with a sus- tained-release option allow patients to use only one drug? What's more, she said it truly has the potential to change a patient's quality of life. "One time I had a patient who was taking four types of drops for glaucoma and I did surgery and he said, 'You don't understand how much you've freed me. I have now free time that I don't know what to do with,'" Dr. Al- Aswad said, speculating that sustained-release drugs could have a similar effect. Dr. Al-Aswad said she thinks patients will be comfortable with sustained-release options because they're already becoming more familiar with them for other ocular conditions that they or their friends might have. Dr. Williamson said the potential to improve compliance and lower IOP without a surgical procedure will be attrac- tive to patients as well. "In my practice and in other surgeons' practices who like the idea of having 100% compliance every time for glaucoma therapy, I think this is going to be a first-line treatment," Dr. Williamson said. important to think about it in terms of the benefit-risk profile. "Does the potential risk of having an implant outweigh the risk of the alternative, which is topical therapy that they're not taking? I would argue that the risk of not taking a drug and risking further visual field loss and blind- ness is worse than any potential issue with the implant or biodegradable itself," he said. Dr. Williamson said sustained drug deliv- ery is the future for glaucoma pharmacologic therapy. "I don't think anyone is going to be using eye drops in our traditional form 25 years from now. It's my prediction that everything is going to be moving toward drug elution or surgical solutions," he said. Another thing he said he would look for- ward to in the future is a sustained drug delivery option that addresses inflow. "If we're combin- ing drug elution with MIGS, all of the MIGS devices work on outflow, so it would be cool to pair that with a drug-eluting device that works on inflow," Dr. Williamson said. Dr. Al-Aswad said sustained-release has the potential to change how physicians think about glaucoma. For example, does a patient continued from page 53 References 1. Glaukos. Accessed March 11, 2020. s21.q4cdn. com/471661912/files/doc_pre- sentations/2019/Glaukos-Presen- tation_January-2019.pdf 2. Brandt JD, et al. Six-month intraocular pressure reduction with a topical bimatoprost ocular insert: results of a Phase II randomized controlled study. Ophthalmology. 2016;123:1685– 1694. 3. Brandt JD, et al. Long- term safety and efficacy of a sustained-release bimatoprost ocular ring. Ophthalmology. 2017;124:1565–1566. Relevant disclosures Al-Aswad: None Williamson: Allergan, Glaukos ASCRS Online Tools Barre Toric Calculator Astigmatism Double Angle Plot Tool Post-Refractive IOL Calculator Hill-RBF Calculator Barre Rx Formula Find the tools, resources, and education you need to enhance your practice and improve your outcomes at: ascrs.org/tools

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