No More Eye Drops For Glaucoma Patients

Drug-Dispensing Eye Insert Shows Promise as an Alternative to Daily Drops for Glaucoma

May 5, 2016

SAN FRANCISCO -- May 5, 2016 -- A new device that slowly releases eye medication may one day be a promising option for the many patients with glaucoma who struggle with administering their own daily prescription eye drops.

New research published today in the journal Ophthalmology shows a medicated silicone ring that rests on the surface of the eye reduced eye pressure in patients with glaucoma by about 20% over 6 months.

Some studies have shown that many patients do not take glaucoma eye drops as directed due to factors such as forgetfulness or physical limitations like arthritis. Some studies have also shown that half of patients stop taking their prescription glaucoma eye drops after 1 year, leaving them vulnerable to vision loss.

Researchers are tackling this challenge of medication adherence with new drug delivery methods. One technology involves a thin silicone ring suffused with medication that slowly releases over time. An ophthalmologist fits the patient with the ring. No surgery is required. The ring is designed to be replaced by an ophthalmologist every 6 months. This eliminates the need for patients to regularly put in medicated eye drops themselves.

Ophthalmologists at 10 sites nationwide tested the ring in a phase 2 clinical trial on patients with glaucoma or ocular hypertension. In the study, 64 patients received the topical ocular insert containing the glaucoma drug bimatoprost. They were also supplied artificial tears. The control group of 66 patients wore an insert treated with no drug but used 0.5% timolol drops twice daily.

Eye pressure in the bimatoprost group fell 3.2 to 6.4 mm Hg over 6 months, compared with 4.2 to 6.4 mm HG for the timolol group.

Overall, eye pressure decreased in the group wearing the bimatoprost ring by about 20% from the initial measurements over 6 months.

The device was well-tolerated and safe, with a high retention rate (89%). The ring became dislodged in 15 patients but was replaced each time, allowing therapy to continue. Some patients experienced itchiness and eye redness, which is not unusual for patients taking glaucoma medication.

“In making effective treatments easier for patients, the hope is that we can reduce vision loss from glaucoma, and possibly other diseases,” said James D. Brandt, MD, UC Davis Medical Center Glaucoma Service, Sacramento, California. “What is exciting is that this is just one of several sustained-release drug delivery methods designed to help patients who have trouble taking daily eye drops.”

A phase 3 study of a larger group of patients is expected to begin later in 2016.

The authors noted the device could also be used for non-glaucoma medications, with potential applications for dry eye, allergies and inflammation. In addition, the non-invasive nature of the device and its relatively large surface area make this technology a potential candidate for delivering multiple ocular drugs at once, further reducing the burden of self-administration on patients.

SOURCE: American Academy of Ophthalmology