ASCRS 2025: Steven R. Sarkisian Jr., MD, ABO, envisions a future without glaucoma drops

At the 2025 American Society of Cataract and Refractive Surgery (ASCRS) meeting in Los Angeles, California, the Eye Care Network spoke with dozens of presenters about the data they brought to the meeting. Steven R. Sarkisian Jr., MD, ABO, presented data from an FDA clinical trial of a travopost intracameral implant. The iDose TR (Glaukos) is indicated for reduction of intraocular pressure (IOP) using a pre-loaded 75 mcg dosage of travoprost. Dr. Sarkisian shared 3-year data on the efficacy of the implant in patients with open-angle glaucoma.

"At all the different time periods, 1-year, 2-year and 3-year...the [IOP lowering] kept enduring," he told the Eye Care Network. "At 3 years, there were just over 6.2 millimeters of mercury [lowering]."

Sustained-release medications such as implants are crucial to compliance, Dr. Sarkisian said. In the FDA clinical trial, Dr. Sarkisian added, 81% of patients were on no additional medications at the 3-year mark. "Most patients with glaucoma are well-controlled with one or two medications," he explained. "The paradigm is shifting. We're talking about doing early, primary [selective laser trabeculoplasty, SLT]."

In the future, Dr. Sarkisian said, a combination of laser treatment such as SLT and an intracameral implant for sustained delivery may change the concept of compliance in glaucoma care. "We're getting to the point where, perhaps, iDose is a second-line treatment, so that we never have to put people on eye drops," he said.