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Glaucoma Physician

Article | 2026 American Glaucoma Society Meeting

Video: Preservative-Free Bimatoprost Gel Represents a New Approach

At the Glaucoma Innovation Summit, Eydie Miller-Ellis, MD, discussed how this next-generation bimatoprost formulation lowers IOP while minimizing ocular surface irritation.

By: Eydie Miller-Ellis, MD,
Glaucoma Physician March 6, 2026
During the Innovation Summit at AGS, Eydie Miller‑Ellis, MD, discussed pharmacokinetic findings and the rationale for the mucoadhesive formulation of Zolymbus (Théa Pharma).

 

This transcript has been edited for clarity.

Hi, I’m Eydie G. Miller-Ellis, MD, and I am director of glaucoma at the University of Pennsylvania Scheie Eye Institute. I had the opportunity to speak at the Innovation Summit at the American Glaucoma Society meeting this year regarding preservative-free bimatoprost 0.01% gel (Zolymbus; Théa Pharma). This is an innovation in terms of the vehicle that the medication is in, because preservative-free drops do not have benzalkonium chloride, or BAK, which facilitates penetration of the active molecule through the cornea to allow it to have its impact on the target tissue in the eye.

The way that Théa got around this was to develop a special gel that has mucoadhesive properties. This allows the medication to remain in contact with the cornea for a longer period of time to facilitate its absorption. It also helps lubricate the ocular surface, because as we are aware, BAK is irritating to the ocular surface, so red eyes and irritation are very much a part of what goes on with our glaucoma patients who are on monotherapy as well as multitherapy. The idea of being able to achieve intraocular pressure (IOP) reduction and protect the ocular surface was the goal here.

The intraocular concentration of the drug was assessed in pharmacokinetic studies in a rabbit model that compared preservative-free bimatoprost 0.01% with the preserved, commercially available bimatoprost 0.01% and bimatoprost 0.03%.1 The concentration in the aqueous humor and in the iris and ciliary body was about the same as with bimatoprost 0.03%, and better than the preserved 0.01%. As you know, the preservative-free formulation is 0.01%, so it does achieve intraocular concentrations somewhat higher than its equivalent preserved formulation. So we’re very excited about having the opportunity to use this in the US market.2 It will be marketed under the name Zolymbus and hopefully will be available toward the end of 2026.

Medical therapy still remains the mainstay of glaucoma treatment, so anything that we can do to achieve IOP reduction and protect the ocular surface is an ideal combination. GP

 

Eydie Miller-Ellis, MD,

Eydie Miller-Ellis, MD,, is a professor of clinical ophthalmology at the Perelman School of Medicine, University of Pennsylvania, and director of the Glaucoma Service and vice-chair of faculty affairs at the Scheie Eye Institute, University of Pennsylvania. She reports consulting fees and research support from Théa Pharma. Reach her at eydie.miller@pennmedicine.upenn.edu.

Reference

  1. Erb C, Topouzis F, Jayaram H, et al. Preclinical and clinical pharmacokinetics of a new preservative-free bimatoprost 0.01% ophthalmic gel to treat glaucoma and ocular hypertension. J Ocul Pharmacol Ther. 2025;41(1):8-16. doi:10.1089/jop.2024.0092

  2. Miller-Ellis E, Peace JH, Day DG, et al. Safety and efficacy of a preservative-free bimatoprost 0.01% ophthalmic gel: results from a phase III controlled trial. J Glaucoma. 2025;34(11):880-887. doi:10.1097/IJG.0000000000002628