Use of Travoprost Sustained-Release Implant in Patient With Early-Stage Glaucoma Undergoing Cataract Surgery

This case study features a 70-year-old female patient with mild open-angle glaucoma and cataracts who desired both drop-free and spectacle-free vision. The patient presented with a history of disc hemorrhage, controlled intraocular pressure on latanoprost, and high myopia (–8 to –9 D). Dr Bedrood selected a light-adjustable lens for optimal refractive outcomes and combined the cataract surgery with an iDose travoprost sustained-release implant to eliminate the need for glaucoma drops.

The surgical approach involved precise placement of the iDose implant into the trabecular meshwork during cataract extraction. The light-adjustable lens was chosen specifically for patients with high myopia requiring customized monovision correction. Postoperative monitoring included specular microscopy for endothelial cell counts and anterior segment OCT imaging to confirm proper implant positioning. The procedure successfully addressed both the cataract and glaucoma management needs simultaneously.

Patient selection criteria for sustained-release implants include good tolerance to prostaglandins, absence of contraindications such as cystoid macular edema or uveitis, and healthy corneal status. The case demonstrated excellent outcomes with the patient achieving 20/20 distance vision, J1+ near vision, and complete elimination of glaucoma medications. This integrated approach represents the future of combined cataract and glaucoma surgery, offering patients improved quality of life through reduced medication burden and enhanced visual function.