Expert Opinion to Optimize Clinical Outcomes of Bimatoprost Intracameral Implant Treatment

Achieving a target intraocular pressure (IOP) in patients with ocular hypertension and open-angle glaucoma has many barriers, some treatment specific and others patient specific. Nonadherence to IOP-lowering eyedrops is one of the major barriers to effective glaucoma treatment. There is a wide range of patients who may benefit from non-topical treatment modalities such as selective laser trabeculoplasty and sustained-release drug delivery, including those who face challenges with topical eyedrops, and those who find benefit in independence from daily medication administration. Sustained-release drug delivery options for lowering IOP include the bimatoprost intracameral implant 10 µg (Bim-I), a relatively new treatment option. This article provides expert opinion on the use of the implant based on available literature, supplementary analysis of clinical trial data, and the experience of the authors who have performed thousands of Bim-I administrations. A single administration of Bim-I has demonstrated the potential to reduce IOP and the need for topical IOP-lowering medication for up to 2 years. Evidence suggests that the safety profile of the implant is most favorable in patients with wide-open (Shaffer grade 4) angles. Recommendations regarding the administration procedure and patient follow-up are provided. The objective of this expert opinion is to help optimize patient selection for Bim-I administration, the implantation procedure, follow-up management, and clinical outcomes while minimizing and addressing potential complications.