By: Roger M. Kaldawy, M.D

Milford Franklin Eye Center

Glaucoma is a condition that can damage our field of vision. It occurs when the pressure inside the eye is higher than what the eye can tolerate. Glaucoma is treatable with drops aimed at lowering eye pressure, but many patients find it challenging to use these drops consistently due to irritation, side effects, or simply forgetting. In these cases, iDose TR, a new sustained-release implant, can offer an innovative solution for managing intraocular pressure without the need for daily eye drops.

What is iDose TR?

iDose TR is an FDA-approved prescription medication and drug delivery system for patients with open-angle glaucoma or ocular hypertension. The implant contains travoprost, a prostaglandin analog that has long been used in eye drops to lower intraocular pressure by increasing the outflow of fluid from the eye. However, unlike traditional drops, iDose TR is gently implanted directly inside the eye, where it releases the drug slowly over time, reducing the need for frequent applications.

How does iDose TR work?

iDose TR delivers a sustained release of travoprost, which helps reduce and maintain healthy eye pressure levels. The tiny implant is placed in the eye’s trabecular meshwork during a minimally invasive procedure performed under local anesthesia at our state-of-the-art surgery center. Once in place, iDose TR continuously delivers the medication for an extended period, reducing the need for daily drops while effectively managing eye pressure.

The implant does not need to be removed, as it is designed to remain in the eye for many months. In some cases, patients may benefit from the iDose TR implant for up to a year or longer before a replacement is needed.

Benefits of iDose TR

iDose TR offers several key advantages over traditional glaucoma treatments:

• Long-lasting effect: Reduces the need for frequent eye drops, improving adherence and convenience.

• Minimally invasive: The implant is inserted via a simple surgical procedure, often performed under local anesthesia.

• Reduced side effects: May result in fewer side effects, such as redness, irritation, and blurry vision, compared to traditional eye drops.

• Improved quality of life: By eliminating the need for daily drops, iDose TR enhances patient comfort and convenience.

Who is a candidate for iDose TR?

iDose TR is approved for patients with open-angle glaucoma and ocular hypertension. However, not every patient is an ideal candidate. Contraindications include:

• Infection or suspected infection in the eye or surrounding area

• Corneal endothelial cell dystrophy or prior corneal transplant

• Narrow angles, where the iris and cornea are too close together

• Allergies to any of the ingredients in the implant

If you meet the criteria, iDose TR may be a great option to help manage your glaucoma and reduce the need for daily eye drops.

Risks of iDose TR

Like any medical treatment, iDose TR comes with some potential risks. While generally well-tolerated, clinical trials have shown the following possible side effects:

• Increased eye pressure

• Eye pain, irritation, or redness

• Inflammation of the iris (iritis)

• Dislocation of the implant (rare)

• Macular edema, a swelling of the retina

• Possible permanent brown pigmentation of the iris

It’s important to discuss any concerns with your ophthalmologist to determine if iDose TR is right for you.

Alternatives to iDose TR

There are several other effective treatments for open-angle glaucoma and ocular hypertension. These include:

• Eye Drops: Prostaglandin analogs (like latanoprost), beta-blockers (timolol), alpha-2 agonists (brimonidine), and carbonic anhydrase inhibitors (dorzolamide) are common options.

• Laser Surgery: Selective laser trabeculoplasty (SLT) and cyclophotocoagulation are minimally invasive procedures to improve fluid drainage or reduce fluid production.

• Surgical Implants: Devices such as the Ahmed glaucoma valve and Ex-PRESS glaucoma implant help drain excess fluid from the eye.

Each treatment has its own set of benefits and risks, and the choice depends on the severity of glaucoma, overall health, and patient preferences. Discuss your options with your ophthalmologist to determine the most appropriate treatment.

Is iDose TR for me?

If you’ve found daily eye drops challenging, or if they haven’t effectively controlled your glaucoma, iDose TR might be the solution you’re looking for. It offers long-lasting pressure control, fewer side effects, and greater convenience, allowing you to focus on living your life without the constant worry of administering drops.

The iDose TR implant helps reduce the burden of daily drops, improving patient compliance and quality of life.  At Milford Franklin Eye Center, we are committed to offering the latest advancements in glaucoma care, including iDose TR. We are proud to have performed one of the first iDose TR procedures in New England at our Cataract and Surgery Center of Milford. As a leader in advanced eye care technology, we are thrilled to be among the pioneers of this groundbreaking treatment. Our surgery and surgeon were featured in a segment broadcasted on Channel 5 TV. We are available for second opinions and dedicated to providing world-class outcomes. Here’s to pushing the boundaries of eye care! 

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