Reimagining Glaucoma Drug Delivery
A drug-eluting IOL may help expand glaucoma treatment options.
“Medicines to lower IOP work very well, but unfortunately they don’t work when patients don’t take them,” remarked Patrick Mooney (CEO of Spyglass Pharma). Presenting at the 2025 Glaucoma 360 New Horizons Forum session “Reimagining Glaucoma Drugs and Drug Delivery,” Mr. Mooney spoke to the difficulties with patient compliance and shared promising initial findings from the feasibility study of a drug-delivering IOL that aims to address this issue.
Combining Medication Delivery With Standard Cataract Surgery
The SpyGlass drug delivery platform consists of a typical hydrophobic lens with 2 drug-eluting pads (pre-loaded with bimatoprost) attached at the haptic–optic junction. The device is placed using standard IOL-implantation techniques, with the pads sitting outside of the visual field, and is designed to provide continuous drug delivery for at least 3 years.
In the recently completed first-in-human phase 1/2 feasibility study, the SpyGlass IOL was inserted in 23 patients with mild-to-moderate open-angle glaucoma or ocular hypertension to assess safety and efficacy. After 18 months, mean IOP reduction was 43.7%, with 96% of patients maintaining pressure at or below 18 mm Hg. Notably, shared Mr. Mooney, all patients remained off topical therapies throughout the study period while maintaining visual acuity of 20/30 or better. In addition, the safety profile was comparable to standard cataract surgery, with reported adverse events limited to typical post-operative symptoms such as dry eye, which was managed with artificial tears.
“Surgeons like what they do. Let’s not change it.”
This combination of a standard IOL with continuous drug delivery could significantly expand options for glaucoma management. Not only does the SpyGlass platform have the potential to remove burden on patients, but it also expands glaucoma surgical care by allowing standard cataract surgery to be leveraged as a glaucoma treatment approach. Mr. Mooney elaborated that according to 2022 Healthcare Medicare Claims, only 35% of cataract surgeons currently incorporate minimally invasive glaucoma surgery into their practice. However, the SpyGlass IOL technology was designed to integrate seamlessly into existing surgical workflows and “requires no deviation from standard cataract surgery techniques.”
Potential for Other Applications
While phase 3 pivotal trials in glaucoma are currently in development, researchers are also exploring potential applications for the SpyGlass drug delivery platform in other areas of ophthalmology. Preclinical studies are under way to evaluate the IOL’s use for drug delivery in cataract surgery (e.g., steroid delivery), while discovery-phase research is examining applications for managing other chronic ocular diseases, including uveitis and age-related macular degeneration. The platform is not yet commercially available, but the company plans to work with the FDA to gain approval pending continued positive clinical trial outcomes.