Use of Bimatoprost Intracameral Implant for the Treatment of Glaucoma: A Focused Narrative Review

The objective of this focused narrative review is to summarize clinical and preclinical evidence on intracameral bimatoprost implants for adults with open-angle glaucoma (OAG) or ocular hypertension (OHT), focusing on comparative efficacy, safety, and adherence-related outcomes. PubMed/MEDLINE and Google Scholar were searched from inception through January 31, 2026, using combinations of the terms bimatoprost implant, bimatoprost sustained-release, bimatoprost SR, Durysta, glaucoma, and ocular hypertension. Eligible reports included human clinical trials or observational studies evaluating any intracameral bimatoprost implant dose in OAG or OHT, and relevant nonclinical pharmacokinetic or pharmacodynamic studies. Conference abstracts without full text and non-English reports were excluded. Records were screened at the title/abstract level followed by full-text review, and data were extracted on intraocular pressure change, need for rescue therapy or additional procedures, treatment-emergent adverse events (TEAEs), and corneal endothelial cell density (CECD). Across phase I/II and phase III trials, bimatoprost implants produced intraocular pressure reductions comparable to topical timolol or topical bimatoprost through early follow-up, and many eyes remained drop-free for months to a year. Corneal adverse events and CECD loss were infrequent after single administration but increased with fixed-interval repeat dosing, with a less favorable profile at higher dose strengths. It was concluded that intracameral bimatoprost implants offer a drop-sparing alternative that may reduce adherence burden, but careful patient selection and monitoring for corneal endothelial effects are central to safe use.