Summary
Dr. Gregory Harmon discusses advances in glaucoma treatment
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While there is still no cure for glaucoma, the past year has seen advances in several aspects of the disease – for example, sustained-release glaucoma medications that can improve compliance and treatment efficiency, devices that help clinicians treat glaucoma, and encouraging research results.
It is estimated that almost half of glaucoma patients do not take their eyedrop medications as prescribed. Adherence and compliance have long been problematic. But recently, two drug delivery systems that are designed to provide continuous drug therapy directly inside the eye have been added to the toolbox for treating open-angle glaucoma and ocular hypertension.
The first was Durysta (AbbVie), an FDA-approved biodegradable implant that dissolves after six months – although some patients have reported a longer time frame. Durysta slowly releases prostaglandin analog that increases the amount of fluid drained from the eye.
Most recently, the FDA approved the iDose® TR (travoprost intracameral implant), manufactured by Glaukos, which is designed to provide up to three years of therapy directly into the eye.
Selective Laser Trabeculoplasty (SLT) has been an important procedure in the treatment of glaucoma and is increasingly being used as an effective early step in treatment. SLT lowers the eye pressure by applying laser energy to the eye’s drainage tissue. It stimulates the trabecular meshwork, the eye’s natural drain, to increase drainage.
A year ago, Belkin Vision’s “Eagle” device, intended for use in performing selective laser trabeculoplasty (SLT), was cleared by the FDA. The Eagle is the first contactless laser for glaucoma, providing an automated and non-invasive procedure. The laser energy is delivered in a non-contact procedure directly to the trabecular meshwork via the cornea without the use of a gonioscopy lens. In addition, the device automatically defines the target location, then applies the laser treatment sequence while the eye tracker compensates for any eye movement. Alcon, Inc. bought Belkin Vision in July.
There also has been encouraging progress in vital research. Of note have been investigations into such areas as gene therapies and stem cell therapies to regenerate and transplant optic nerve cells in individuals with retinal degenerative diseases, AI algorithms to improve early diagnosis, and research to identify additional genes associated with an increased risk for developing glaucoma.