Glaucoma is a progressive optic neuropathy that can potentially result in blindness [1]. Increased intraocular pressure (IOP) is the only modifiable risk factor for glaucoma. Topical antiglaucoma medications are commonly used to lower IOP, thereby preventing optic nerve thinning and associated visual field changes [2], [3]. Prior studies have demonstrated that non-adherence to topical antiglaucoma drops is approximately 30% to 80%, which may be associated with difficulty in eye drop administration; forgetting prescribed medication regimen; and medication costs [2], [4], [5]. Alternative mechanisms for medication administration may circumvent compliance issues and, subsequently, slow glaucoma progression.

Intracameral Bimatoprost sustained release (SR) is a biodegradable implant that was approved by the United States Food and Drug Administration in March 2020 for one-time use in patients with ocular hypertension and open angle glaucoma (OAG). Implant administration is performed using a single-use 28-gauge applicator at the slit lamp or in a procedure room. Prior to reformulation as an implant, topical administration of Bimatoprost at a dose of 0.01% and 0.03% demonstrated efficacy in IOP reduction [6]. Phase I, II, and III data showed that 10 and 15 μg Bimatoprost SR implants were similarly safe and effective in lowering IOP in patients with OAG and ocular hypertension [7], [8], [9].

To date, additional phase IV real-world studies examining the efficacy of bimatoprost SR in the treatment of glaucoma have been limited. Moreover, there is limited data examining efficacy of bimatoprost SR in clinically complex patients, particularly in patients with prior glaucoma surgery.

The aim of the present study was to evaluate IOP and use of glaucoma medications after bimatoprost SR implantation. A secondary objective of the study was to examine the effect of Bimatoprost SR in patients with a history of minimally invasive and incisional glaucoma surgery.