Clinical trial data indicate that a novel cataract intraocular lens may also address glaucoma. The lenses embed tiny reservoirs of bimatoprost, a common glaucoma medication, that slowly dispense the drug within the eye, according to researchers presenting at the American Academy of Ophthalmology’s annual conference.
One procedure for two conditions
Raised intraocular pressure damages the optic nerve, leading to vision loss in glaucoma. Reducing this pressure remains the sole established method to decelerate disease progression, typically involving daily eye-drop regimens. However, maintaining adherence to drops administered once or twice each day proves challenging, investigators noted.
A large proportion of older adults develop cataracts, characterized by opacification of the natural lens. Cataract extraction combined with insertion of an artificial lens is now among the most routinely performed and reliable surgeries globally. This prompted the concept of loading intraocular lenses with glaucoma medication.
The study enrolled 106 participants diagnosed with glaucoma or ocular hypertension who were slated for cataract extraction. Seventy-five percent were randomly allocated to receive the test lenses, designed to release either a low or high concentration of bimatoprost. The other 25% received a conventional intraocular lens and were prescribed timolol eye drops twice daily.
One year later, mean intraocular pressure measured 15.9 mmHg in the high-dose cohort, 14.8 mmHg in the low-dose cohort, and 15.7 mmHg among participants with the conventional lens plus drops. Over 95% of individuals implanted with the drug-eluting lens required no additional glaucoma therapy after twelve months.
Performing one surgery that simultaneously treats two separate eye disorders is uncommon, particularly among older adults where glaucoma and cataracts frequently coexist. Merging the interventions into a single operation streamlines care and lessens the administrative and adherence challenges for patients who would otherwise need to follow rigorous drop schedules.
Longer follow-up planned
The investigators highlighted the potential impact. “Imagine being able to treat two of the most common eye diseases, cataract and glaucoma, in one sitting,” researcher Dr. Jeffrey Kammer, an ophthalmologist at Vanderbilt University Medical Center in Nashville, said in a news release. “There is simply nothing like it in development.”
The study participants will remain under observation for a three-year period, and investigators indicated that two more extensive follow-up trials have commenced. “Longer-term follow-up will be important for understanding the durability of pressure control as well as safety,” Kammer said. “Glaucoma treatment is moving toward solutions that could make managing the disease simpler.”