Procedural Pharmaceutical Lessons From Early Adopters

Experienced glaucoma surgeons share practical pearls on integrating sustained drug delivery into practice.

By: Christine Funke, MD, J. Morgan Micheletti, MD, FACS, Jason Bacharach, MD, Shivani S. Kamat, MD, Arkadiy Yadgarov, MD, Steven R. Sarkisian, Jr., MD, Robert F. Melendez, MD, MBA, Syril K. Dorairaj, MD, and, Pranav Vasu, MPH, Savak “Sev” Teymoorian, MD, MBA, Reza Alizadeh, MD, Lorraine M. Provencher, MD, Jai G. Parekh, MD, MBA, FAAO, Manjool Shah, MD, Inder Paul Singh, MD, Huda Sheheitli, MD, Reena A. Garg, MD, Zarmeena Vendal, MD

Glaucoma Physician September 1, 2026 Page(s): 16-20

Clinical Scorecard: Procedural Pharmaceutical Lessons From Early Adopters

At a Glance

Category	Detail
Condition	Glaucoma Management
Key Mechanisms	Sustained drug delivery systems for intraocular pressure (IOP) control.
Target Population	Patients with open-angle glaucoma seeking alternatives to daily topical therapy.
Care Setting	Clinical practice integrating sustained-release pharmaceuticals.

Key Highlights

Two FDA-approved sustained-release options: Durysta and iDose TR.
Patient-centered discussions are crucial for treatment selection.
Sustained drug delivery can reduce the burden of daily medication.
Combining procedural pharmaceuticals with other therapies can enhance IOP control.
Patient selection is key for successful outcomes.

Guideline-Based Recommendations

Diagnosis

Assess IOP and glaucoma severity to determine treatment options.

Management

Consider sustained drug delivery as an alternative or adjunct to topical medications.

Monitoring & Follow-up

Regular follow-up to evaluate IOP control and adjust treatment as necessary.

Risks

Potential for ocular surface irritation and cost-related barriers to medication adherence.

Patient & Prescribing Data

Patients controlled on a single glaucoma medication seeking to reduce or eliminate drops.

Patients often prefer sustained drug delivery options to avoid the challenges of daily medication.

Clinical Best Practices

Frame discussions around the benefits of sustained drug delivery for IOP control.
Individualize treatment plans based on patient preferences and clinical needs.
Utilize gonioscopy to assess suitability for procedures.