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    Punctal plug drug delivery attractive method for managing glaucoma

    Punctal plug-based delivery systems for sustained delivery of glaucoma medications represent new and versatile technology that is under development.

    The hope is it can help with the problem of patient compliance when managing mild-moderate glaucoma, said Marlene Moster, MD, during Glaucoma Subspecialty Day at the 2017 meeting of the American Academy of Ophthalmology

    “We know that compliance matters in glaucoma therapy,” said Dr. Moster, private practice, Bala Cynwyd, PA, and an attending surgeon, Wills Eye Hospital, Philadelphia.

    “But, one study of glaucoma monotherapy found that 25% of patients took less than 75% of doses and almost 20% of patients took less than 50% of their doses, even though they knew they were being monitored electronically.”

    While there is also interest in developing intraocular and extraocular platforms for sustained delivery of glaucoma medications, punctal plug delivery offers some attractive features.

    First, they represent a non-invasive intervention, and there is huge experience with punctal plugs in ophthalmology.

    “Punctal plugs for dry eye have become a well-accepted therapeutic solution when topical preparations are not effective,” Dr. Moster said.

    In addition, punctal plugs can be removed, made to dissolve, and if one configuration does not work, another shape can be tried. They can also be made to fit all sizes of puncta.

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