Travoprost Intracameral Implant in Eyes with Glaucoma or Ocular Hypertension: Early Short-Term Real-World Outcomes

Purpose: To assess real-world efficacy and safety of standalone travoprost intracameral implant (iDose TR) implantation by a US glaucoma surgeon in patients with open-angle glaucoma (OAG) or ocular hypertension (OHT). Methods: This non-randomized, retrospective, unmasked, consecutive case series included all cases of standalone iDose TR implantation from a single US glaucoma surgeon since the product's approval by the US Food and Drug Administration (FDA) in December 2023. Patients were pseudophakic, had OAG or OHT, and had undergone prior SLT and/or bimatoprost intracameral implant injection (Durysta). Intraocular pressure (IOP), medications, and adverse events were evaluated through 3 months postoperatively. Results: All patients (n=65 eyes) were implanted with iDose TR and experienced no intraoperative complications. In the consistent cohort of eyes with 3-month follow-up data (n=54), mean IOP reduced from 19.6 +/- 3.8 mmHg preoperatively to 13.1 +/- 2.5 mmHg at 3 months (33.2% reduction, p=0.001). The percentage of eyes with IOP <= 15 mmHg increased from 11.1% preoperatively to 83.3% at 3 months (p=0.001). Mean number of IOP-reducing medications reduced from 0.28 +/- 0.71 preoperatively to 0.0 +/- 0.0 at 3 months (100% reduction; p=0.006). The percentage of eyes off topical medication increased from 85% preoperatively to 100% at 3 months. One eye was reported to have mild iritis at 1-2 weeks postoperatively, and was treated with a topical prednisolone acetate taper. No secondary procedures occurred in any eye. Conclusion: Standalone implantation of the travoprost intracameral implant yielded statistically and clinically significant IOP and medication reductions through 3 months in eyes with prior SLT and/or bimatoprost intracameral implant injection with favorable safety. Plain Language Summary: This short-term real-world consecutive case series assesses the efficacy and safety of the novel travoprost intracameral implant (iDose TR) in actual clinical practice. Clinically and statistically significant reductions in intraocular pressure (IOP; 33.2% reduction) and topical medications were achieved, together with favorable safety. After the procedure, there was over a seven-fold increase in the percentage of eyes with IOP <= 15 mmHg, and 100% of eyes were free of topical medications (versus 85.2% preoperatively). This publication is the first real-world study in the literature to-date on this novel technology.