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Sebastiao Cronemberger, Juçara R Franca, Alan Cezar Faria Araújo, Francine Rubião da Cunha, André Augusto Gomes Faraco, Anderson Ferreira, Giselle Foureaux; Effectiveness and Safety of Topical Bimatoprost Insert for Primary Open-Angle Glaucoma and Ocular Hypertension Treatment. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2109.
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Primary open-angle glaucoma (POAG) is initially treated with daily instillation of eye drops which are effective but may have adverse effects. Polymer systems of extended-release drugs may reduce these effects and improve adherence to treatment. We have developed an insert for sustained release of bimatoprost.After, we assessed in patients with ocular hypertension (OH) or POAG the efficacy and safety of bimatoprost inserts in one eye compared to Lumigan™ eye drops in the contralateral eye.
All patients underwent the following exams by the same doctor: visual acuity measurement, slit lamp examination, Goldmann applanation tonometry, ultrasonic pachymetry, fundus examination and visual field testing. Inclusion criteria were both eyes with IOP>21mmHg without medication at 8:00 to 9:00 am; normal biomicroscopy; no antiglaucomatous or refractive surgery. Five normal patients with IOP≤14mmHg were also included. An insert of chitosan for prolonged release of bimatoprost was placed in the upper conjunctival fornix of the right eye (Fig. 1). In the left eye, patients instilled one drop of Lumigan™ daily at 9:00 pm. All exams were repeated weekly at 8:00 to 9:00 am for six weeks except the visual field. Anova two-way, Student test and paired-t test were used for statiscal analysis. The level of significancy was set at 0.05.
No intolerance or discomfort with the insert was reported by the patients. In both eyes (insert and eye drop), the average IOP reduction was similar in the initial 3 weeks (insert: 31.2±10.3%, and eye drops: 34.8±10.1%). The percentage of IOP reduction at the end of the 3rd week was of 30% for insert and of 35% for eye drops (Fig. 2). A research conducted by CTIT/UFMG with participants demonstrated that 58% prefer insert; 25% prefer eye drops and 17% have no preference. Insert runs in 83.3% of patients and 58% of them would change the instillation of the eye drops to inserts. The reasons are practicality of the insert; forgetfulness (instilling eye drops) and higher price of eye drops.
The insert of bimatoprost reduced significantly the IOP, similarly to what happened with Lumigan™ eye drops, for 3 weeks. The use of insert can be an alternative to daily instillation of eye drops for the treatment of POAG or OH.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
Insert (upper fornix)
% of IOP reduction at 3 weeks
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