Eyeworld

MARCH 2021 | EYEWORLD | 99 G by Liz Hillman Editorial Co-Director About the physicians Amy Mehta, MD SightMD New York, New York Joseph Panarelli, MD Chief of the Glaucoma Service New York Langone Health New York, New York References 1. Craven ER, et al. 24-month phase I/II clinical trial of bimato- prost sustained-release implant (bimatoprost SR) in glaucoma patients. Drugs. 2020;80:167–179. 2. Medeiros FA, et al. Phase 3, randomized, 20-month study of bimatoprost implant in open-an- gle glaucoma and ocular hyper- tension (ARTEMIS 1). Ophthal- mology. 2020;127:1627–1641. Relevant disclosures Mehta: None Panarelli: Allergan Durysta a year later: Physicians discuss early experience This is a 72-year-old African American male with newly diagnosed primary open-angle glaucoma, mild stage. The patient reported non-compliance with prostaglandin analog eye drops due to forgetting to take the drops. Here is the right eye inferior anterior chamber angle with the Durysta pellet sitting in the angle 30 minutes after injection of Durysta implant at the slit lamp. Source: Amy Mehta, MD D urysta, the sustained-release bimato- prost implant, 10 mcg (Allergan), has been available with FDA approval in the U.S. market for a year now. EyeWorld spoke with two physicians, Amy Mehta, MD, and Joseph Panarelli, MD, who started offering it as an option to their patients to hear about their experience thus far. Early experiences Both Dr. Mehta and Dr. Panarelli said the patients who have received Durysta in their practice have had a good response to it. They are not necessarily offering it extensively but are trying to figure out where it fits in the treatment algorithm. "I'm trying to find the right place for it in my treatment regimen. … We have so many diff- erent treatment modalities available to us. It's hard to figure out what is the best option for each person sitting in front of us," Dr. Panarelli said. Good candidates Dr. Panarelli said there are two groups of pa- tients for whom he is finding Durysta to be most helpful: 1) those with ocular surface disease and 2) those with compliance issues. "There are a good number of patients who have issues with topical medications, either the preservatives or the medication itself irritates the ocular surface. … Even for a period of 6 months to a year, if we can get them off topical therapy and improve their surface, that's a big win for us," he said. Those who have issues with compliance might be forgetting their drops or have trouble administering them physically. Dr. Panarelli also said he's had a small number of other patients who are benefiting from Durysta during the pandemic. "I have a handful of patients who, given the pandemic, aren't excited about the idea of having surgery because of the many postoper- ative visits required. [Durysta] has been a nice bridge, a treatment option to put off or delay more invasive surgical interventions," he said. Dr. Mehta thinks Durysta could also be an interesting option for cataract surgery patients who have glaucoma. Due to the number of drops associated with cataract postop routines, she said that taking away a glaucoma drop by using the sustained-release implant can be helpful in this timeframe. She also found it useful for a patient of hers who was undergoing chemotherapy. "She's going to be on a lot of medications for the next few months and this is a way to ease her burden by taking something out of her life that she doesn't have to remember," Dr. Mehta said. Dr. Mehta said she tries to use Durysta on patients who have already shown they respond to bimatoprost or another prostaglandin analog. "It's nice for me to know they've had a good response to that medication," she said, adding that one patient was given Durysta as a first- line therapy after she tried him for a couple of weeks on Lumigan (bimatoprost, Allergan) to determine his response. continued on page 100

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