Durysta Implant for Glaucoma Treatment in Evansville
Durysta implant is a treatment alternative for some patients with open-angle glaucoma (OAG) or ocular hypertension (OHT). The implant was approved by the FDA in March 2020[2][3][5]. It is the first biodegradable sustained-release implant that continuously delivers Bimatoprost, a prostaglandin analog, within the eye that helps reduce and maintain healthy eye pressure levels[2][3]. The preservative-free medication is housed within a tiny rod-shaped cartridge that is inserted in the eye’s anterior chamber by an ophthalmologist during a safe 5-minute office procedure[2][4].
The Durysta implant is designed to last 4 – 6 months, which means that patients will only have to follow-up with their eye doctor two or possibly three times per year to have the medication implant inserted in their eye[2]. Unlike eye drops, the Durysta implant, implanted in the intracameral cavity, allows the medication to directly reach the target tissue in the eye. This can help ensure more consistent drug delivery and provide more sustained IOP control compared to eye drop formulations[4]. In contrast with eye drops, Durysta delivers the medication continuously to the target tissue, which helps prevent fluctuations in intraocular pressure that can frequently occur with eye drops[4].
The efficacy of the bimatoprost implant was investigated in two 20-month phase III trials involving 1,122 subjects that were randomized to treatment with the implant versus topical timolol eye drops. Patients that were randomized to the bimatoprost implant had the drug administered in the study eye on day 1, week 16, and week 32. Patients randomized to topical timolol were treated with twice daily dosing[3]. The bimatoprost implant is contraindicated in individuals with active or suspected ocular or periocular infections, corneal endothelial cell dystrophy, prior corneal transplantation, absent or ruptured posterior lens capsule, and in individuals with a history of hypersensitivity to bimatoprost[3].
The great news for patients with open-angle glaucoma (OAG) and ocular hypertension (OHT) is that the Durysta implant is designed to last 4 – 6 months, which means that they will only have to follow-up with their eye doctor two or possibly three times per year to have the medication implant inserted in their eye[2]. Unfortunately, in the USA, the FDA has only approved the treatment for a one time use. It can, however, be used off label at the discretion of the physician and patient when medically necessary. During a short, in-office or outpatient procedure, Dr. Malitz will insert the Durysta implant into the front part of the eye, in front of the iris (the colored part of the eye). The Durysta implant is a small, flexible, and white about the size of a grain of rice. The eye will be numbed with eye drops and the implant will be inserted in the front of the eye with a specially designed and approved device.
Glaucoma is a progressive disease of the eye that can lead to irreversible vision loss and blindness. A big challenge in managing open-angle glaucoma (OAG) and ocular hypertension (OHT) has been getting patients to comply with taking medicated eye drops essential for managing intraocular pressure (IOP). In fact, 80% of glaucoma patients do not use their prescribed topical drops as instructed, either due to side effects or forgetfulness[2]. That is why the Durysta implant was invented. Durysta is a breakthrough in the treatment of open-angle glaucoma or ocular hypertension that just obtained FDA approval. Durysta (made by Allergan) has been a valuable tool for those patients who have difficulty taking daily medicated eye drops for glaucoma because it may free patients from having to apply drops altogether for a period of time[2].
In the phase III studies evaluating the implant, the most common ocular adverse reaction was conjunctival hyperemia in 27% of patients. Other adverse reactions reported in 5-10% of patients included foreign body sensation, eye pain, photophobia, conjunctival hemorrhage, dry eye, eye irritation, increased intraocular pressure, corneal endothelial cell loss, blurred vision, and iritis, [3].
In conclusion, the Durysta implant is a new treatment for open-angle glaucoma (OAG) and ocular hypertension (OHT) that was approved by the FDA in March 2020. It is the first biodegradable sustained-release implant that continuously delivers Bimatoprost, a prostaglandin analog, within the eye that helps reduce and maintain healthy eye pressure levels. The preservative-free medication is housed within a tiny rod-shaped cartridge that is inserted in the eye’s anterior chamber by an ophthalmologist during a safe 2-minute outpatient procedure. The Durysta implant is designed to last up to 6 months, which means that patients can reduce or eliminate the use of drops for a period of time and may decrease office visits. Unlike eye drops, the Durysta implant, implanted in the intracameral cavity, allows the medication to directly reach the target tissue in the eye. This can help ensure more consistent drug delivery and provide more sustained IOP control compared to eye drop formulations.
Citations:
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7303088/
[2] https://assileye.com/library/durysta-implant-for-glaucoma
[3] https://eyewiki.aao.org/Durysta_(Bimatoprost_Implant)
[4] https://www.teceyecare.com/durysta-bimatoprost-implant-everything-you-need-to-know
[5] https://www.biospace.com/article/fda-greenlights-allergan-s-durysta-implant-for-glaucoma/
[6] https://glaucomatoday.com/articles/2023-may-june-insert/real-world-experience-implementing-sustained-release-medication-in-the-glaucoma-treatment-paradigm