Abstract
Purpose :
Bimatoprost sustained-release (Bimatoprost SR, Durysta, Allergan) is a biodegradable implant that is administered intracamerally to reduce intraocular pressure (IOP) in patients with ocular hypertension or open angle glaucoma (OAG). To date, the efficacy and safety of Bimatoprost SR in patients with prior glaucoma surgery have not been examined. The aim of the present study is to evaluate outcomes of Bimatoprost SR implantation in patients with prior minimally invasive glaucoma surgery (MIGS) or incisional glaucoma surgery.
Methods :
A retrospective chart review of 122 eyes that received Bimatoprost SR by six glaucoma specialists at Wills Eye Hospital between March 2020 and September 2021 was performed. Patients were included if they had prior iStent, goniotomy, trabeculectomy, or tube shunt surgery. Statistical analyses, including paired t-tests, were performed.
Results :
A total of 41 eyes (39 OAG and 2 chronic angle closure) from 32 patients were included. Median age was 76 years and 24 (75%) patients were women. Of the 41 eyes, 25 (61%) had iStent implantation, 4 (10%) had goniotomy, 5 (12%) had trabeculectomy, 2 (5%) had tube shunt, and 5 (12%) had both trabeculectomy and tube shunt surgery prior to Bimatoprost SR implantation. Mean follow-up time was 26.9 ± 18.9 weeks after implantation. Mean IOP after Bimatoprost SR implantation (16.7 ± 5.0 mmHg) was similar to pre-treatment IOP (17.5 ± 4.5 mmHg, p=0.37). Patients required significantly fewer medications to control IOP after Bimatoprost SR implantation (1.2 ± 1.2) compared to baseline (1.9 ± 1.2, p<0.001). Two (5%) eyes required additional tube shunt surgery after Bimatoprost SR. No patient had long-term complications following Bimatoprost SR implantation.
Conclusions :
Patients who received intracameral Bimatoprost SR with a history of prior glaucoma surgery subsequently required fewer IOP-lowering medications. The present data suggest that Bimatoprost SR may be a valuable alternative treatment option in patients with prior glaucoma surgery.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.