Latest / Glaucoma, Vision & Longevity: Supplements & Science / New Glaucoma Treatments in 2026: What Patients Should Know About Longer-Lasting Eye Pressure Control

Transcript

New Glaucoma Treatments in 2026: What Patients Should Know About Longer-Lasting Eye Pressure Control · Glaucoma, Vision & Longevity: Supplements & Science

• 0:00
  SPEAKER_00: New glaucoma treatments for 2026.
• 0:02
  SPEAKER_00: Longer lasting pressure control.
• 0:04
  SPEAKER_00: Glaucoma, a leading cause of vision loss, is driven by high intraocular pressure in the eye.
• 0:11
  SPEAKER_00: Daily eye drops are the main treatment, but many patients find them hard to use consistently.
• 0:17
  SPEAKER_00: Drops can sting, cause redness, or simply be forgotten in the busy routines of life.
• 0:22
  SPEAKER_00: Missing doses can let eye pressure creep up, risking vision loss.
• 0:26
  SPEAKER_00: Sustained release glaucoma treatments aim to solve this by steadily delivering medication without daily drops.
• 0:33
  SPEAKER_00: Instead of an eye drop bottle, a doctor places a tiny implant or device that continuously releases glaucoma medicine for months.
• 0:41
  SPEAKER_00: These approaches remove the need to remember daily drops and help keep pressure controlled around the clock.
• 0:47
  SPEAKER_00: Below we explain how these new treatments work, who might benefit, and how they compare to traditional drops.
• 0:55
  SPEAKER_00: We focus on the options most talked about for 2026, separating those already FDA approved from those still being studied.
• 1:03
  SPEAKER_00: How sustained release treatments work.
• 1:06
  SPEAKER_00: Traditional glaucoma drops deliver medication onto the eye surface, but much of it washes away before it can work.
• 1:12
  SPEAKER_00: Sustained release devices sit inside the eye or on eye tissue and let out drugs slowly over time.
• 1:18
  SPEAKER_00: For example, Derista is a tiny biodegradable rod, about 1.1 mm long, that an eye doctor injects into the anterior chamber, the front part of the eye.
• 1:28
  SPEAKER_00: It contains 10 micrograms of bimatoprost, the medicine in lumagin drops, embedded in a dissolving polymer.
• 1:35
  SPEAKER_00: Once placed, durista releases bimatoprost steadily for about four to six months.
• 1:41
  SPEAKER_00: The implant then dissolves on its own, so no second procedure is needed.
• 1:45
  SPEAKER_00: Another approach used by IDose TR is a tiny titanium implant anchored into the eye wall.
• 1:51
  SPEAKER_00: This anchoring device contains a reservoir of Travoprost, another prostaglandin drug.
• 1:56
  SPEAKER_00: About 75 micrograms of travoprost continuously elutes, seeps out into the eye through a controlled membrane.
• 2:03
  SPEAKER_00: The Idose TR device stays in place for up to two to three years, delivering medication 24-7.
• 2:10
  SPEAKER_00: As of early 2026, the FDA has even approved readministering Idose TR when the first dose runs out.
• 2:17
  SPEAKER_00: Both DERISTA and IDOS TR release prostaglandin-type drugs that help fluid drain out of the eye, lowering pressure.
• 2:24
  SPEAKER_00: Similarly, experimental implants like OTX tick Paxtrava, PA5108, and ENV5115 are designed as tiny biodegradable implants or particles that doctors insert into the eye.
• 2:36
  SPEAKER_00: They work the same way.
• 2:37
  SPEAKER_00: A drug, e.g.
• 2:39
  SPEAKER_00: travoprost or latanoprost, is slowly released over months.
• 2:42
  SPEAKER_00: Punctal plugs, by contrast, sit in the tear drainage ducts near the nose and gently release medication into the tears.
• 2:50
  SPEAKER_00: Each system steadily bathes the eye in medicine, nearly eliminating the peaks and troughs of pressure seen with once daily drops.
• 2:58
  SPEAKER_00: Who might benefit?
• 3:00
  SPEAKER_00: These devices are best for people with open-angle glaucoma or ocular hypertension who need regular IOP control but struggle with daily drops.
• 3:08
  SPEAKER_00: Older patients, those with limited mobility or trouble handling eye drops, or anyone who missed doses are prime candidates.
• 3:16
  SPEAKER_00: Because the drugs are in continuous contact with the eye, these devices often work as well as or better than drops, while leaving the patient with fewer steps in daily routine.
• 3:27
  SPEAKER_00: FDA-approved drop-free options, Durista, Bimataprost implant.
• 3:31
  SPEAKER_00: Durista from Abvi was FDA approved in 2020 for open-angle glaucoma and ocular hypertension.
• 3:37
  SPEAKER_00: It is a single-use implant.
• 3:39
  SPEAKER_00: A doctor injects it into the lower part of the anterior chamber, often at the slit lamp.
• 3:45
  SPEAKER_00: The tiny rod contains 10 micrograms of bimatoprost and slowly biodegrades over about 4 to 6 months, releasing drug.
• 3:53
  SPEAKER_00: Clinical trials showed derista lowered eye pressure by an average of 5 to 8 mmHg grams, 30% from baseline, over 12 weeks, about the same as twice daily Tolol eye drops.
• 4:05
  SPEAKER_00: In a long-term study, over 70% of eyes needed no additional pressure lowering treatment for 18 months after one derista implant.
• 4:13
  SPEAKER_00: Remarkably, some patients maintain good pressure control for up to two years from a single implant in trials.
• 4:20
  SPEAKER_00: Once darista dissolves, no implant removal is needed.
• 4:23
  SPEAKER_00: Because the polymer degrades, derista is not meant to be repeated often.
• 4:28
  SPEAKER_00: In fact, it is approved only once per eye.
• 4:31
  SPEAKER_00: Studies found repeated implants could harm the corneal lining, so clinicians currently give derista just once.
• 4:37
  SPEAKER_00: A common side effect is eye redness, about 27% of patients.
• 4:42
  SPEAKER_00: Other side effects mirror those of prostaglandin drops, like temporary vision change or eye irritation.
• 4:48
  SPEAKER_00: Importantly, darista was not approved in Europe due to corneal safety concerns, but it remains available in the US.
• 4:55
  SPEAKER_00: Pros and cons versus drops.
• 4:57
  SPEAKER_00: Durista lets you skip drops for many months.
• 5:00
  SPEAKER_00: In trials, pressure reduction with darista was non-inferior to tymolol drops.
• 5:05
  SPEAKER_00: It bypasses the ocular surface, so less irritation or preservative exposure.
• 5:10
  SPEAKER_00: On the downside, getting durista requires an injection, though it's done with a fine needle at the slit lamp, and the minor risks that come with any intraocular procedure.
• 5:20
  SPEAKER_00: And because it releases a fixed drug dose, adjustments in therapy are harder than with drops.
• 5:25
  SPEAKER_00: Idose TR, travoprost implant.
• 5:28
  SPEAKER_00: Idose TR, glucose, is an implantable tiny cylinder made of medical-grade titanium that anchors into Schlem's canal, the natural drainage channel of the eye.
• 5:39
  SPEAKER_00: It holds 75 mitrograms travoprost and is designed to release drug continuously for about two years.
• 5:45
  SPEAKER_00: The first FDA approval came in December 2023 for one-time use in each eye for open-end glaucoma or ocular hypertension.
• 5:54
  SPEAKER_00: In clinical trials, one eye dose TR implant lowered IOP by 6 to 8.5 millimeter grugs, comparable to Timolol drops over three months.
• 6:02
  SPEAKER_00: Crucially, 12 months after implantation, 81% of patients were completely off-glaucoma drops, and many stayed well controlled on no additional medication for years.
• 6:12
  SPEAKER_00: Early data suggested about 70% still had good pressure control at three years with the same or fewer medications.
• 6:20
  SPEAKER_00: Common side effects in 2-6% of patients included mild inflammation, iretis, slight pressure rise, dry eye, or redness.
• 6:28
  SPEAKER_00: Eye redness was actually much lower, 3% than with prostaglandin drops.
• 6:33
  SPEAKER_00: In January 2026, the FDA allowed IDose TR to be readministered to a patient if the first implant's benefit wanes.
• 6:41
  SPEAKER_00: That means doctors can now implant a new IDO TR in the same eye after proper evaluation without increasing corneal risk.
• 6:49
  SPEAKER_00: This is a big advantage.
• 6:50
  SPEAKER_00: Unlike Derista, Idose TR does not dissolve and can potentially be exchanged or refilled.
• 6:56
  SPEAKER_00: Pros and cons versus drops.
• 6:58
  SPEAKER_00: Idose TR works all day and night without relying on patient compliance.
• 7:02
  SPEAKER_00: It uses a preservative-free Travoprost formula, so ocular surface side effects are minimal.
• 7:09
  SPEAKER_00: In trials, it matched drops in lowering pressure and dramatically cut the need for drops.
• 7:14
  SPEAKER_00: On the other hand, it requires an invasive procedure, similar to placing some microstents and carries surgical risks.
• 7:21
  SPEAKER_00: If something goes wrong, e.g.
• 7:23
  SPEAKER_00: discomfort or implant issues, removing or stopping the device is more involved than stopping a drop.
• 7:29
  SPEAKER_00: Also, it is currently indicated only for open-angle glaucoma, and certain eye conditions, like corneal dystrophy or infections, would make it unsuitable.
• 7:39
  SPEAKER_00: Other sustained release treatments in development.
• 7:42
  SPEAKER_00: Besides derista and Idose TR, many new long-acting treatments are being tested.
• 7:47
  SPEAKER_00: These are not yet FDA approved, but they show promise.
• 7:50
  SPEAKER_00: Paxtrava, OTX TIC, this is a trade name for a travoprost implant by ocular therapeutics.
• 7:56
  SPEAKER_00: Like Dorista, it is a biodegradable implant injected into the anterior chamber.
• 8:01
  SPEAKER_00: In a phase 2 study, a single Paxtrava implant, 26 mitrograms travoprost, lowered IOP by about 24 to 30% at six months.
• 8:11
  SPEAKER_00: In that trial, 81% of treated eyes needed no extra pressure lowering therapy for the full six months.
• 8:17
  SPEAKER_00: The implant mostly dissolved by six months in many patients, suggesting it could be redosed.
• 8:22
  SPEAKER_00: Paxtrava was well tolerated, with mostly mild side effects.
• 8:26
  SPEAKER_00: The company is now planning phase 3 trials toward FDA approval, but it's still experimental.
• 8:32
  SPEAKER_00: Latanoprost implant, Polyactiva PA518, developed by Polyactiva, this is a microscopic intraocular implant containing latanoprost free acid.
• 8:43
  SPEAKER_00: It is injected through a tiny needle 27 gauge into the anterior chamber.
• 8:47
  SPEAKER_00: It releases latanoprost over about six months.
• 8:50
  SPEAKER_00: A phase two study is underway, comparing two doses of this implant, including a repeat dose at 26 weeks, against daily eye drops.
• 8:59
  SPEAKER_00: Early reports say the implant biodegrades in about four to six weeks, allowing another dose later.
• 9:05
  SPEAKER_00: In one trial of 75 patients, each got one implant and switched at 26 weeks.
• 9:10
  SPEAKER_00: Full results are not published yet, but the company says it met safety and efficacy goals.
• 9:15
  SPEAKER_00: ENV Phi-15, Invisia.
• 9:18
  SPEAKER_00: EN515 is an investigational travoprost implant made with nanoparticle technology.
• 9:24
  SPEAKER_00: A phase 2A study, completed in 2017, showed that ENV515 lowered IOP by roughly 6.7 mm grams, 28% at 25 days, similar to once daily travoprost drops.
• 9:37
  SPEAKER_00: The implant was well tolerated with no serious adverse events in three months.
• 9:42
  SPEAKER_00: A higher dose version was tested for 11 months in the 2017 data, with both low and high doses giving sustained IOP lowering, the high dose worked better.
• 9:51
  SPEAKER_00: These results suggest EN515 can safely release travoprost for many months.
• 9:56
  SPEAKER_00: Further studies are needed, and this device remains experimental.
• 10:01
  SPEAKER_00: Punctal plug systems.
• 10:02
  SPEAKER_00: Companies have also tried inserting drug-filled plugs into the tear ducts, punctua.
• 10:07
  SPEAKER_00: For example, Matty Therapeutics made a latanoprost punctal plug with a polymer core releasing 141 mg of latanopost.
• 10:15
  SPEAKER_00: In a phase 2 trial, plugging the tears with latanoprost plugs in 95 patients dropped IOP by about 5.7 mmhergrams on average over four weeks.
• 10:25
  SPEAKER_00: About 60% of patients had a pressure drop of at least 5 mmhergrams.
• 10:30
  SPEAKER_00: Side effects were mostly mild, watering eyes, minor discomfort.
• 10:34
  SPEAKER_00: Another design was a travoprost plug, Ocular Therapeutics OTXTP, a dissolving hydrogel rod that swells and releases travoprost for about 90 days.
• 10:43
  SPEAKER_00: It lowered pressure, but less than a TML drop, and only 42% of plugs stayed in place after one month.
• 10:51
  SPEAKER_00: Discomfort and even canaliculitis tear duct infection were reported.
• 10:55
  SPEAKER_00: No active trials of travoprost plugs are ongoing.
• 10:59
  SPEAKER_00: In short, punctal plugs can deliver glaucoma drugs in theory, but they face limits.
• 11:04
  SPEAKER_00: They can only hold so much medication, they may not stay in the correct place, and so far their pressure-lowering effect has been modest.
• 11:12
  SPEAKER_00: Research continues on better punctal devices, for example, new Evolute plugs by MATI that recently contained Travoprost, but none are on the market yet.
• 11:21
  SPEAKER_00: Other investigational approaches.
• 11:23
  SPEAKER_00: Beyond the above, many innovative ideas are in the pipeline, though mostly for future years.
• 11:29
  SPEAKER_00: For example, a few companies are working on a drug-eluding intraocular lens, IOL, a cataract lens that slowly releases glaucoma medicine for up to two to three years.
• 11:40
  SPEAKER_00: Early human results, MAR225, were impressive.
• 11:43
  SPEAKER_00: Patients who got a bimatoprost releasing IOL during cataract surgery saw their IOP drop by 11 mm, 43.7% at 18 months, and all stayed off glaucoma drops.
• 11:54
  SPEAKER_00: There are also drug-eluding contact lenses under study.
• 11:57
  SPEAKER_00: One, LLBMT1, is a soft lens that releases bimatoprost.
• 12:02
  SPEAKER_00: A phase 2B trial showed about 5.5 mm grams pressure reduction after three weeks.
• 12:08
  SPEAKER_00: Another idea is in tiny implantable eyelid patch that sits under the eyelid, a Morphex's TOD D, releasing medicine over months.
• 12:16
  SPEAKER_00: These are still in early, preclinical, or phase two stages.
• 12:20
  SPEAKER_00: In addition, Glaucose itself has future IDOS candidates under development.
• 12:24
  SPEAKER_00: Glaucos recently noted it is working on IDOS TREX and other next generation IDOS implants for even longer drug delivery.
• 12:32
  SPEAKER_00: TREX is believed to be an acronym hinting at an extended Travoprost or Letanoprost release.
• 12:39
  SPEAKER_00: It's not yet specified when these will be available, but they are in clinical trials, comparing new treatments with daily drops, convenience and compliance.
• 12:48
  SPEAKER_00: All these sustained release options share one big advantage.
• 12:51
  SPEAKER_00: They free patients from daily drops.
• 12:53
  SPEAKER_00: In trials, both Darista and Idose TR kept pressure down as well as daily drops and allowed most patients to stop the extra drops completely.
• 13:02
  SPEAKER_00: For example, a year after one eye dose TR, 81% of patients were off all eye drops.
• 13:08
  SPEAKER_00: Many stayed that way even at three years.
• 13:10
  SPEAKER_00: With DERISTA, most eyes needed no further medication for over a year.
• 13:15
  SPEAKER_00: This continuous delivery avoids the peaks and lapses of once-a-day dosing and can greatly simplify life for patients struggling with complicated drop schedules.
• 13:24
  SPEAKER_00: Efficacy.
• 13:25
  SPEAKER_00: So far, clinical trials show these implants can lower IOP roughly as much as standard drops.
• 13:30
  SPEAKER_00: Durista reduced IOP by about 30%, 5-8mm in trials, and IDOSETR gave a similar 6-8mm herbs drop.
• 13:39
  SPEAKER_00: Early trials of OTX TIC and others show comparable drops, 25% over six months.
• 13:46
  SPEAKER_00: In a way, they work just like an always-on drop of the same drug.
• 13:50
  SPEAKER_00: It's important to remember, no device cures glaucoma.
• 13:53
  SPEAKER_00: All they do is lower pressure just as drops would.
• 13:56
  SPEAKER_00: If one drop, like Litanoprost, was your best choice, a sustained release version of that drug should work similarly.
• 14:02
  SPEAKER_00: Side effects and risks.
• 14:04
  SPEAKER_00: Sustained release eye treatments avoid some issues of drops but introduce others.
• 14:09
  SPEAKER_00: Almost all side effects of glaucoma drugs stem from the medicine itself.
• 14:14
  SPEAKER_00: E.g., prostaglandin drops can cause iris color changes, eyelash growth, or flare-ups of optic nerve swelling.
• 14:20
  SPEAKER_00: These effects still occur with implants, though often at lower rates.
• 14:24
  SPEAKER_00: Idose TR had much less eye redness than typical drops.
• 14:29
  SPEAKER_00: The major new risks come from the procedure or device.
• 14:32
  SPEAKER_00: For intracameral implants, there is a small risk of eye infection or bleeding with insertion.
• 14:38
  SPEAKER_00: Some implants, derasta, have been linked to corneal cell loss if repeated too often.
• 14:43
  SPEAKER_00: Anchored devices like Idose should not move around, but doctors must monitor implant position 13.
• 14:50
  SPEAKER_00: Punctal plugs risk eyelid irritation or caniliculitis infection in the tear duct.
• 14:55
  SPEAKER_00: Contact lenses or IOLs with drug could cause small surgical risks or lens fogging, not yet fully known.
• 15:02
  SPEAKER_00: All new devices are under close study for unexpected problems.
• 15:06
  SPEAKER_00: Importantly, surgical versus non-surgical.
• 15:08
  SPEAKER_00: Drops have hardly any surgical risk but rely on you.
• 15:11
  SPEAKER_00: Implants require a one-time doctor procedure, often office-based.
• 15:15
  SPEAKER_00: For many patients, that trade-off is worth it, one quick procedure every year or two, in exchange for better control and fewer drops.
• 15:22
  SPEAKER_00: Approved versus experimental.
• 15:24
  SPEAKER_00: As of 2026, only DERISTA and IDOSE TR are FDA approved and available.
• 15:30
  SPEAKER_00: In the US, doctors can order these now for appropriate patients, and they may be covered by insurance, like other prescription treatments.
• 15:38
  SPEAKER_00: All other items mentioned, OTX TIC, PAFF 108, ENV515, punctal plugs, new IDOS versions, etc., are still in clinical trials or development.
• 15:50
  SPEAKER_00: That means they are not yet widely available.
• 15:53
  SPEAKER_00: It could take a few more years of study and regulatory review before any of these reach the market.
• 15:58
  SPEAKER_00: Meanwhile, researchers will quiz these new devices for lasting effect and safety in larger groups and compare them to standard care.
• 16:07
  SPEAKER_00: Bottom line, if you hear buzz about these treatments, know that only the two approved implants are options today.
• 16:14
  SPEAKER_00: Others are hopeful candidates for the near future, but not substitutes for your current therapy right now.
• 16:21
  SPEAKER_00: Talk to your eye doctor to understand what is available and what still needs more testing.
• 16:26
  SPEAKER_00: Conclusion.
• 16:27
  SPEAKER_00: New glaucoma therapies promise to transform treatment from daily drops to shot-in-the-arm care.
• 16:33
  SPEAKER_00: Durista and eye dose TR have shown that one implantation can control eye pressure as well as daily drops for months or years.
• 16:42
  SPEAKER_00: This can greatly relieve busy patients of eye drop burden and improve compliance.
• 16:46
  SPEAKER_00: On the horizon are several similar implants, e.g., Paxstrava OTX TIC, PA5108, ENV515, and devices like drug-plug tear ducts or medicated contact lenses, which could further extend the time between treatments.
• 17:01
  SPEAKER_00: However, every option has trade-offs.
• 17:03
  SPEAKER_00: Implants require a clinic procedure and carry small surgical risks, whereas drops avoid that but demand strict self-care.
• 17:10
  SPEAKER_00: Some implants, like Durista, are currently one-time use only, while others, like the new IDOS, allow redosing.
• 17:17
  SPEAKER_00: Cost, insurance coverage, and availability vary, so none of these should be pursued without a doctor's advice.
• 17:25
  SPEAKER_00: What patients should know?
• 17:27
  SPEAKER_00: Talk with your ophthalmologist if you have trouble with drops or have been uncontrolled on medications.
• 17:32
  SPEAKER_00: The pros of sustained release implants include freedom from daily dosing and steady 24-7 medication, which many patients find convenient.
• 17:42
  SPEAKER_00: The cons include a minor procedure and potential side effects like any glaucoma drug.
• 17:47
  SPEAKER_00: For now, the choice of therapy depends on your individual condition and preferences.
• 17:52
  SPEAKER_00: As research progresses, we can hope for even more long-lasting, drop-free glaucoma treatments to become available in the coming years.
• 18:02
  SPEAKER_00: Talk to your doctor about whether a sustained release implant is right for you, and keep an eye on the horizon.
• 18:08
  SPEAKER_00: New devices may soon make managing glaucoma easier than ever.
• 18:12
  SPEAKER_00: All links to sources are available in the text version of this article.
• 18:17
  SPEAKER_00: You can find the full article at VisualFieldTest.com.
• 18:21
  SPEAKER_00: Thanks for listening.
• 18:22
  SPEAKER_00: To check your visual field, click the link at the bottom of this article or visit VisualFieldTest.com.