BIMATOPROST VS TRAVOPROST SUSTAINED-RELEASE IMPLANTS

This review and analysis was performed to evaluate the efficacy and safety of sustained-release intracameral prostaglandin analog implants, including bimatoprost (Durysta) and travoprost (iDose TR), in patients with open-angle glaucoma (OAG) or ocular hypertension (OHT).

A systematic review and pooled quantitative analysis were performed according to PRISMA guidelines. PubMed, Scopus, Embase, and Google Scholar were searched for studies published between 2020 and 2025 evaluating sustained-release intracameral prostaglandin implants. Randomized and non-randomized studies reporting intraocular pressure (IOP) and safety outcomes were included.

Six studies comprising 1,047 eyes met inclusion criteria. Bimatoprost implants (10 µg and 15 µg) achieved mean IOP reductions of 6.1–6.7 mmHg at 12 months, whereas pooled slow-eluting travoprost implant data demonstrated reductions ranging from 5.5 to 7.75 mmHg depending on study design and follow-up duration. 

Subgroup analysis demonstrated comparable efficacy between travoprost and bimatoprost implants at 3 months; however, at 12 months, travoprost efficacy was lower than the 15 µg bimatoprost implant while remaining comparable to the 10 µg implant. 

Most adverse events were mild and transient. Corneal endothelial cell loss occurred in a dose-dependent manner with repeated bimatoprost administrations, particularly with the 15 µg implant, whereas no significant endothelial cell loss was reported with travoprost implants. Both implants substantially reduced topical medication burden.

The study concluded that sustained-release intracameral prostaglandin implants provide durable IOP reduction while decreasing dependence on topical therapy. 

REFERENCE:

Chopra AL, Siringoringo C, Siu S, Francis B, Mahdavi Fard A. Sustained-Release Intracameral Prostaglandin Analog Implants for Glaucoma: Comparative Review and Meta-Analysis of Bimatoprost and Travoprost Delivery Systems. J Ocul Pharmacol Ther. 2026 Aug 3:10807683261474828. doi: 10.1177/10807683261474828. Epub ahead of print. PMID: 42544565.

DOES LATANOPROST EXACERBATE RGC LOSS?

 

INTRODUCTION:

Parvin Niknam and colleagues from the Mayo Clinic, USA, have compared diazoxide (DZ), an ATP-sensitive potassium channel opener and latanoprost free acid (LFA), the active metabolite of the prostaglandin analogue latanoprost, on IOP, retinal ganglion cell (RGC) density, retinal morphology, and glial cell activation in the DBA/2J mouse model of pigment dispersion glaucoma.

Therapeutics that open ATP-sensitive potassium (KATP) channels, such as diazoxide (7-chloro−3-methyl-4H−1,2,4-benzothiadiazine 1,1-dioxide; DZ), are an emerging strategy for IOP reduction and direct neuroprotection through multiple mechanisms.

DZ is an FDA approved agent for treating hyperinsulinism and hyperphagia in Prader-Willi Syndrome, and to treat systemic hypertension.

METHODOLOGY:

DBA/2J mice age 4 months received daily topical applications of DZ (5 mM) or LFA (0.1 mM) in one eye, while the fellow eye received the vehicle. IOP was measured prior to treatment and twice weekly throughout the 23-week treatment period. Immunofluorescence staining was used to quantify RGC density with RNA binding protein with multiple splicing (RBPMS) and glial cell activation as a measure of neuroinflammation with glial fibrillary acidic protein (GFAP). Hematoxylin and eosin staining was used to evaluate retinal morphology.

RESULTS:

The study was significant in that it found that IOP was reduced by both DZ (30%) and LFA (24%) for a portion of the experimental period. However, importantly, DZ did not alter RGC survival, reactive gliosis, or RGC morphology. Conversely, LFA treatment was associated with a significant reduction in RGCs, an increase in reactive gliosis, and altered RGC morphology characteristic of cell death.

CONCLUSION:

The study concluded that DZ lowered IOP without notable retinal side effects. In contrast, LFA reduced IOP but was associated with enhanced RGC neurodegeneration and increased neuroinflammation.

The findings suggest that prostaglandin analog therapy might carry risks of enhanced neurodegeneration in eyes with pre-existing pro-inflammatory microenvironments, though further research is needed outside the DBA/2J strain.

REFERENCE:

Parvin Niknam, Mohammed E. Omer, Kjersten J. Anderson, Tommy A. Rinkoski, Uttio Roy Chowdhury, Gavin W. Roddy. Daily topical latanoprost free acid exacerbates retinal ganglion cell degeneration in the DBA/2J mouse model of pigment dispersion glaucoma. Prostaglandins & Other Lipid Mediators, Volume 186, 2026, 107101, ISSN 1098-8823. https://doi.org/10.1016/j.prostaglandins.2026.107101.