Eyeworld

100 | EYEWORLD | MARCH 2021 G UCOMA by Ellen Stodola Editorial Co-Director Contact Mehta: amehta@sightmd.com Panarelli: joepanarelli@gmail.com Reimbursement Dr. Mehta said patients need to have Medicare plus a secondary insurance, with the secondary insurer being one of the larger companies. "The process for signing someone up for Durysta has been lengthier than SLT or some- thing like that. Typically, I talk to the patient about it, they fill out a form, we call them after it's been approved, then we schedule it for them," she said. Patient hesitation Dr. Panarelli said that some patients are initially weary of having an injection in their eye, but with a little more explanation, many become more comfortable. "The majority of patients after the proce- dure is done find it was a rather easy experi- ence," he said. Dr. Mehta hasn't had any patients who expressed fear of the injection. Administering the implant Dr. Mehta said all of her Durysta injections have been done at the slit lamp or in a minor proce- dure room at her office. She said that you can get approved to do it at an ASC, but she has not yet performed it on any patients at an ASC. Dr. Panarelli also said he has been injecting Durysta in the office at the slit lamp. What's next? "I think that if you're taking care of glaucoma patients, you want something that will help them in the long run. Durysta isn't giving them that complete lifetime coverage but it does help us in improving quality of life even temporari- ly," Dr. Mehta said, adding that there are studies being done to look at multiple or longer lasting sustained-release of Durysta. Currently, one Durysta implant is de- signed to last several months, but a Phase 1/2, dose-ranging study found that one Durysta implant controlled IOP in 40% of patients for up to 12 months and 28% of patients for up to 24 months. 1 A Phase 3 study designed to evaluate different doses and up to three implants found that IOP was controlled at 1 year. 2 Dr. Panarelli said it's great to have a new product, and he thinks with more time physi- cians will begin to see where it fits into their individual treatment regimens. "One of the questions many of us continue to ask is how far will this go? Should we use this product first line? Second line? We just don't know yet," he said, adding later that if real-world use demonstrates the safety and effi- cacy seen in the trials, he thinks use of Durysta will expand. Streamlining glaucoma care continued from page 99 E yeWorld spoke with several glaucoma specialists who discussed changes they've noticed in glaucoma as well as in their own practices due to the COVID-19 pandemic. They shared how they've adapted to continue patient care and described the changes they think are here to stay post-pandemic. Changes in response to COVID-19 Sarwat Salim, MD, said that she has noticed tre- mendous collaboration and a multi-disciplinary approach to research, evidence-based medicine, education, advocacy, and the use of technology and telemedicine platforms in the past year. "It is wonderful to see how different organiza- tions are partnering as we navigate the rapidly evolving COVID-19 crisis," she said. "Each day we are learning, growing, and developing new strategies to protect our patients and staff and to ensure the best possible clinical practices and outcomes." Inder Paul Singh, MD, has noticed a change in patients in that they are carefully observing all the new requirements in the practice. They are watching staff actions and changes to pro- tocols, like mask wearing and cleaning, he said. Dr. Singh thinks it's important to maintain these protocols long term to protect patients, physi- cians, and office staff. continued on page 102

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