Glaucoma update

Eyeworld

A new refillable and programmable drug delivery system for glaucoma that could also change treatment approaches to many ocular diseases in the future was described. Designed to solve glaucoma patient compliance issues, the device (REPLENISH, Pasadena Calif.), is implanted in the patient’s eye through minimally invasive surgery, and supplies the appropriate amount of drug needed at determined intervals into the anterior chamber, said Mark S Humayun M.D., Ph.D., Los Angeles. The intraocular drug pump, which is made of biocompatible material, can last between five to 10 years and can be refilled while implanted. Pre-clinical trials showed successful transconjunctival refilling every four to six weeks for a period of four to six months. In addition, Dr. Humayun said, switching medications in between refills is possible as the device is able to flush out its reservoir. In the future, the system may also be designed to include two chambers for delivery of two drugs. Concerns with the device include endothelial damage, infection, tube clogging and the amount of drug that remains in the reservoir.
Looking further into the future, Stuart J McKinnon, M.D., Ph.D., Durham, N.C., presented hope for glaucoma specialists trying to reduce intraocular pressure in their patients. Dr. McKinnon described the possibility of neuroprotective treatment for glaucoma. He explored three strategies including blocking the formation or aggregation of amyloid-β, complement activation, and tumor necrosis factor-α signalling, and said they represented considerable promise.