Experts in NHS Lothian are trialling a microscopic eye implant to revolutionise glaucoma treatment.
The team, led by Dr Andrew Tatham (above) at the Princess Alexandra Eye Pavilion, are conducting a study of the pioneering biodegradable device.
The implant, which is similar in size to a grain of sand, is carefully positioned inside the eye to deliver medicine directly to where it is most needed.
The team, which are conducting trials as part of an international collaboration, are confident the breakthrough can ease side effects, deliver more effective treatment and revolutionise current care.
Dr Tatham said: “This is really exciting. It provides the potential to change the way we treat glaucoma forever.
“There is a great need to develop more effective ways of treating glaucoma that don’t rely on delivering medication using eye drops. The implant lasts for up to a year, but in the future there is potential for sustained release medications that last several years.
“The procedure is completely painless and recovery is also immediate. It is even possible to drive home after.”
In Scotland, glaucoma affects one to two per cent of people over the age of 40, and five per cent of those aged 75 and over.
It is a leading cause of blindness and until now, patients with glaucoma have relied on eye drops to deliver the vital medication they require on a daily basis to preserve their vision. Some patients require multiple drops each day.
The condition is caused by a problem with the eye’s plumbing system. Fluid inside the eye is unable to drain, which causes a build-up of pressure damaging the nerve connecting the eye to the brain.
Nerve damage is irreversible so it is important to identify glaucoma at an early stage and start the treatment to help preserve vision.
However, the drops can be difficult to use, frequently cause dry and red eye, and patients often forget to use them, but Dr Tatham believes eye drops could become a thing of the past.
Results so far have found that 80 per cent of patients treated with the implant have been able to stop their eye drops for at least a year.
The rod-shaped pellet is inserted into the eye in a quick, painless procedure lasting just a few minutes. First, a few numbing drops are applied to the eye and the device is inserted carefully into the eye’s front chamber.
Made of a biodegradable material known as polymer matrix, the pellet then begins to dissolve, releasing vital medication for up to a year until it disappears entirely. When the effects of the implant have worn off, the procedure can be repeated as often as needed.
The implant contains a medication called Bimatoprost. Bimatoprost has been used for many years as a component of eye drops, but by delivering the medication as an implant, a much smaller quantity of drug is needed. The implant contains the same amount of Bimatoprost as a single eye drop.
Research suggests the Bimatoprost SR implant treatment is just as effective as regular drops, and it is being trialled at NHS hospitals as part of an international study. Dr Tatham said: ‘There are potentially millions of people around the world who could benefit from this drop-free treatment.
The trial of Bimatoprost SR is taking place in NHS hospitals including Moorfields in London and Addenbrooke’s in Cambridge, is comparing the implant with another effective glaucoma treatment called selective laser trabeculoplasty.
The laser treatment called SLT (Selective Laser Trabeculoplasty) is a painless procedure where a laser is used to open the eye’s natural drainage channels. A study published in the Lancet this year showed 75% of people treated with laser still don’t need eye drops 3 years after treatment. Dr Tatham’s research team are currently examining whether there are any differences between laser or the implant.
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