Outcomes of Bimatoprost sustained-release intracameral implant in patients with glaucoma

Abstract

Purpose : Bimatoprost sustained-release intracameral implant (Bimatoprost SR, Durysta, Allergan) was approved by the U.S. Food and Drug Administration for one-time use in patients with ocular hypertension or open angle glaucoma (OAG) in March 2020. The purpose of the present study is to determine real-world outcomes of Bimatoprost SR on intraocular pressure (IOP) and number of IOP lowering medications in patients with glaucoma. A secondary objective is to determine the efficacy of Bimatoprost SR in patients with a prior history of selective laser trabeculoplasty (SLT).

Methods : 122 eyes that received Bimatoprost SR by six glaucoma specialists at Wills Eye Hospital from March 2020 until September 2021 were examined using a retrospective chart review. A paired sample t-test for IOP and a binomial change test for number of medications was used. Multilevel models were then used to determine if statistical significance remained when controlling for demographic variables and prior history of SLT utilizing the lme4 package in R.

Results : Of the 122 eyes, there were 113 OAG, 4 chronic-angle closure, 3 ocular hypertension, and 2 others. 46 (54%) patients were female, and the median age was 78 years old. Mean follow-up time was 26.9 ± 18.9 weeks. 82 (67%) eyes were on a topical prostaglandin medication prior to intracameral Bimatoprost SR injection. 68 (83%) of these eyes stopped topical prostaglandin medication after injection. Mean post-treatment IOP of 16.6 ± 5.3 mmHg was significantly lower than mean pre-treatment IOP of 18.5 ± 5.8 mmHg (t=-3.50, p <0.01). The average number of medications following Bimatoprost SR was 1.3 ± 1.3, which was significantly lower than the average number of pre-treatment medications of 2.1 ± 1.4 (p<0.01). Analysis of multilevel models demonstrated that there was a statistically significant reduction in IOP and number of medications post-treatment even when demographic variables were controlled for (p<0.01 for both). A prior history of SLT (n=54) had no impact on treatment outcomes for IOP or number of medications, when controlling for demographics (p>0.1 for both).

Conclusions : Intracameral Bimatoprost SR reduced IOP and decreased the number of medications. Prior history of SLT did not impact Bimatoprost SR treatment outcomes.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.