Clinical Ophthalmology (Mar 2024)
Real-World Analysis of the Efficacy of Bimatoprost Sustained-Release Glaucoma Implant Where American Indians Comprise the Largest Minority Population
Abstract
Steven R Sarkisian Jr,1 Evann C Mitchell2 1Research & Clinical Trials, Oklahoma Eye Surgeons, Oklahoma City, OK, USA; 2College of Medicine, University of Oklahoma, Oklahoma City, OK, USACorrespondence: Steven R Sarkisian Jr, Research & Clinical Trials, Oklahoma Eye Surgeons, 5600 N Portland Ave, Oklahoma City, OK, 73112, USA, Tel +1405 943-4413, Fax +1405 942-0115, Email [email protected]: To assess the effectiveness and safety of bimatoprost sustained release (SR) glaucoma implant as a treatment for open-angle glaucoma and ocular hypertension in a real-world private practice setting with a significant American Indian population.Methods: This retrospective study included 156 eyes from adult patients who received a single injection of bimatoprost implant between June 2020 and May 2022 at the Oklahoma Eye Surgeons. Patients were stratified by baseline intraocular pressure (IOP) (≥ 21 mmHg versus IOP< 21 mmHg). The co-primary endpoints were changes in the mean IOP and the number of topical IOP-lowering medications from baseline to Month 6.Results: At 6 months, eyes with baseline IOP≥ 21 mmHg had a significantly lower mean IOP (19.85± 8.01 versus 26.25± 4.84 mmHg; p< 0.0001) and the mean number of IOP-lowering medications (1.04± 1.44 versus 1.38± 1.50; p=0.048) compared with baseline. One year after implantation, 73.58% of eyes had a ≥ 20% reduction in IOP, 41.51% were medication-free and 30.19% were receiving at least one fewer medication. Among eyes with baseline IOP< 21 mmHg, there was a significant reduction in the mean number of IOP-lowering medicines by Month 6 (0.61± 1.03 versus 1.93± 1.21 at baseline; p< 0.0001), with no change in IOP. At 12 months, 24.27% of eyes had a ≥ 20% decrease in IOP, 43.69% of eyes did not require any medications and 63.11% had at least one fewer medication compared with baseline. An analysis using Welch’s two-sample t–test showed no significant differences in the outcomes between the overall population and the American Indian population (number of eyes, 23).Conclusion: Bimatoprost SR glaucoma implant lowered IOP in eyes with high, uncontrolled baseline IOP, while it reduced the number of medications in eyes with a controlled baseline IOP. No clinically meaningful and statistically significant differences in the efficacy of bimatoprost were observed in patients of American Indian descent.Keywords: intraocular pressure, open-angle glaucoma, ocular hypertension, prostaglandin analog, intracameral implant, ethnicity/race
