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Long-Term Chronic Drop Therapy vs. Intracameral Procedural Pharmaceuticals for Glaucoma: What Does the Evidence Support?

Shivani Kamat, Cristophe Baudouin, Manjool Shah, Nathan Radcliffe

Topical ocular medications are traditionally considered to be first-line therapies for glaucoma and ocular hypertension. However, long-term therapy with topical medications can be difficult for the ocular surface to tolerate, has significant cost, results in frequent suboptimal patient compliance, and can adversely affect patient quality of life. Intracameral implants have been developed to overcome the physical barrier of the ocular surface by bypassing the cornea and conjunctival tissues for intraocular delivery. These drug delivery systems are designed to deliver therapeutic concentrations of medication in a continuous fashion to the target tissues. The implants have demonstrated durable intraocular pressure-lowering effects with favorable safety and varying key distinguishing characteristics. They have the potential to occupy an important position in the ophthalmologists’ armamentarium for treating glaucoma and ocular hypertension, including at earlier stages in the treatment journey.