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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

Clinical Report: Preservative-Free Bimatoprost Gel Represents a New Approach

Overview

Expand on the mucoadhesive properties and their role in enhancing drug absorption.

Background

Glaucoma remains a leading cause of irreversible blindness, necessitating effective management strategies to lower IOP. Traditional glaucoma therapies often include preservatives that can irritate the ocular surface, leading to patient non-compliance. The development of preservative-free formulations is crucial for improving tolerability and adherence in glaucoma treatment.

Data Highlights

FormulationIOP ReductionOcular Surface Irritation
Preservative-Free Bimatoprost 0.01%Comparable to preserved bimatoprost 0.01%Less aggravation of conjunctival hyperemia
Preserved Bimatoprost 0.01%StandardHigher irritation reported

Key Findings

  • The preservative-free bimatoprost gel achieves IOP reduction comparable to preserved formulations.
  • It demonstrates improved ocular surface tolerability due to the absence of benzalkonium chloride (BAK).
  • Pharmacokinetic studies indicate higher intraocular concentrations than preserved bimatoprost 0.01%.
  • The gel's mucoadhesive properties enhance contact time with the cornea, facilitating absorption.
  • FDA approved the gel for use in the U.S. market, expected to be available by late 2026.

Clinical Implications

The introduction of preservative-free bimatoprost gel offers a promising alternative for glaucoma patients, particularly those experiencing ocular surface irritation from traditional therapies. Clinicians should consider this formulation to enhance patient compliance and treatment outcomes.

Conclusion

Preservative-free bimatoprost 0.01% gel represents a significant advancement in glaucoma therapy, balancing effective IOP reduction with improved ocular surface safety. Its anticipated availability will provide clinicians with a valuable tool in managing glaucoma.

References

  1. Miller-Ellis E, Peace JH, Day DG, et al., J Glaucoma, 2025 -- Safety and efficacy of a preservative-free bimatoprost 0.01% ophthalmic gel: results from a phase III controlled trial.
  2. Glaucoma Physician — Video: Preservative-Free Bimatoprost Gel Represents a New Approach Recommendations
  3. Glaucoma Physician — Trial Data Show Preservative-free Benefit for Glaucoma Treatment
  4. Ophthalmology Management — Transforming the glaucoma treatment paradigm
  5. Glaucoma Physician — The Glaucoma Therapy Pipeline
  6. Video: Preservative-Free Bimatoprost Gel Represents a New Approach Recommendations
  7. Trial Data Show Preservative-free Benefit for Glaucoma Treatment
  8. Transforming the glaucoma treatment paradigm
  9. AAO Primary Open-Angle Glaucoma Preferred Practice Pattern Guideline Summary
  10. Preservative-Free Bimatoprost 0.01% Ophthalmic Gel for Glaucoma Therapy: A Phase III Randomized Controlled Trial - PMC
  11. Preclinical and Clinical Pharmacokinetics of a New Preservative-Free Bimatoprost 0.01% Ophthalmic Gel to Treat Glaucoma and Ocular Hypertension