EFFICACY OF BIMATOPROST SUSTAINED-RELEASE IMPLANT (BIMATOPROST SR) IN TREATING SEVERE INTRAOCULAR PRESSURE IN OPEN GLAUCOMA: A SYSTEMATIC REVIEW & META-ANALYSIS

Background: Glaucoma, a leading cause of irreversible blindness, is characterized by progressive optic neuropathy resulting from elevated intraocular pressure (IOP). The bimatoprost implant, a sustained-release and biodegradable solution, can be inserted into the eye's anterior chamber to reduce IOP in patients with open-angle glaucoma (OAG). However, additional research is necessary to comprehensively evaluate the efficacy of the bimatoprost 10 µg implant in treating OAG patients compared to other available treatment options.

Aims & Objectives: This study aimed to systematically review and meta-analyze the efficacy and safety of the bimatoprost 10 µg implant in managing severe intraocular pressure in patients with OAG.

Methods:  This meta-analysis of recent randomized controlled trials (RCTs) adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Protocols to ensure methodological rigor and address the research aims. To identify relevant research articles, a comprehensive search was conducted across four electronic databases: PubMed, EMBASE, Cochrane Library, and clinicaltrials.gov. Primary outcomes included intraocular pressure (IOP), rescue rate, proportion of individuals achieving desired IOP reduction, and adverse events. The Cochrane Risk of Bias tool was employed to assess the methodological quality of each included RCT. Pooled analysis was performed using RevMan (Review Manager) software version 5.4.

Results:

A meta-analysis of twelve studies involving 2808 OAG patients aged 60-80 with severe or uncontrolled IOP found that the bimatoprost SR implant is effective and safe in lowering IOP. The implant significantly reduced IOP levels compared to placebo, as demonstrated by a mean difference of -1.53 mmHg (95% CI: -0.43 to -2.64). Additionally, the implant was associated with a slight increase in the proportion of patients with reduced IOP (OR: 0.70, 95% CI: 0.57-0.86) and a modest increase in the rescue rate (OR: 2.02, 95% CI: 0.55-7.52). The bimatoprost SR implant was well-tolerated, with fewer adverse events and no treatment-emergent adverse events (TEAEs) reported in the treatment group compared to the placebo.

Conclusion: This meta-analysis demonstrated that the bimatoprost implant is an effective and safe option for treating OAG by reducing intraocular pressure IOP. However, further research is warranted to fully evaluate its potential for delaying disease progression. Given its efficacy in managing severe glaucoma, the bimatoprost SR implant may be a valuable tool for optimizing IOP control and improving patient outcomes.