Sustained-Release Intracameral Prostaglandin Analog Implants for Glaucoma: Comparative Review and Meta-Analysis of Bimatoprost and Travoprost Delivery Systems.

PURPOSE: To evaluate the efficacy and safety of sustained-release intracameral prostaglandin analog implants, including bimatoprost (Durysta) and travoprost (iDose TR), in patients with open-angle glaucoma (OAG) or ocular hypertension (OHT).

METHODS

A systematic review and pooled quantitative analysis were performed according to PRISMA guidelines. PubMed, Scopus, Embase, and Google Scholar were searched for studies published between 2020 and 2025 evaluating sustained-release intracameral prostaglandin implants. Randomized and nonrandomized studies reporting intraocular pressure (IOP) and safety outcomes were included.

RESULTS

Six studies comprising 1,047 eyes met inclusion criteria. Bimatoprost implants (10 µg and 15 µg) achieved mean IOP reductions of 6.1-6.7 mmHg at 12 months, whereas pooled slow-eluting travoprost implant data demonstrated reductions ranging from 5.5 to 7.75 mmHg depending on study design and follow-up duration. Subgroup analysis demonstrated comparable efficacy between travoprost and bimatoprost implants at 3 months; however, at 12 months, travoprost efficacy was lower than the 15 µg bimatoprost implant while remaining comparable to the 10 µg implant. Most adverse events were mild and transient. Corneal endothelial cell loss occurred in a dose-dependent manner with repeated bimatoprost administrations, particularly with the 15 µg implant, whereas no significant endothelial cell loss was reported with travoprost implants. Both implants substantially reduced topical medication burden.

CONCLUSIONS

Sustained-release intracameral prostaglandin implants provide durable IOP reduction while decreasing dependence on topical therapy. Although efficacy differences between travoprost and bimatoprost implants appear modest, their safety profiles differ, particularly regarding corneal endothelial effects. Further long-term comparative studies are warranted.