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    New glaucoma drug delivery devices home in on compliance

    New Orleans—Patient compliance (and non-compliance, as the case may be) is nothing new when discussing glaucoma.

    Nor are the multiple devices and systems previously developed or under investigation with the hope of improving compliance, said Richard Lewis, MD, speaking at Glaucoma Day at ASCRS 2016.

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    “We’ve been talking about compliance for as long as I can remember,” Dr. Lewis said. “And we’ve been trying to address the issue for just as long a time. Alternatives to eye drops were described as early as 1976, with the Ocusert implant.”

    Ocusert was basically pilocarpine in a delivery system put into the lower cul-de-sac. The issue with the system was that it first delivered too much medication, which led to side effects, and then when the system delivered too little medication, there was little drug effect, he said.

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    “The problem was there were complications that sometimes couldn’t be overcome and it wasn’t a very successful product commercially,” he said. “But the problem of patient compliance with traditional topical medications has not dissipated. We need better medications delivered for a longer duration.”

    A potentially viable option to deliver drugs is through punctal plugs, but “they have to be retained in the eye and that’s been an obstacle,” Dr. Lewis said.

    At issue are the higher retention rates needed to ensure punctal plugs remain commercially viable.

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    “The disadvantages beyond retention are directional flow and topical effect,” he said.

    Too many earlier versions would end up in the nasal area instead of the eye, Dr. Lewis said.

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