BIM-IOL Lowers IOP 35%, Ends Drops for Most Patients: Fiaz Zaman, MD

A drug-eluting intraocular lens (IOL) implanted during cataract surgery kept intraocular pressure (IOP) under control for 12 months while freeing most patients from daily glaucoma drops, according to Fiaz Zaman, MD, FACS, ophthalmologist at Houston Eye Associates, who discussed interim phase 1/2 results at the American Academy of Ophthalmology 2026 Annual Meeting.

The Bimatoprost Drug Pad-IOL (BIM-IOL) System, developed by SpyGlass Pharma, uses 2 drug-eluting pads attached to the lens to deliver bimatoprost continuously. The trial randomly assigned 104 patients with mild to moderate open-angle glaucoma or ocular hypertension to 1 of 2 BIM-IOL doses or to a standard IOL plus timolol drops.¹

At 12 months, mean IOP fell by about 9 mm Hg, or roughly 35%, comparable with the timolol control group. “Normally we’d like to see at least a 25% to 30% decrease in pressure with initial therapy,” Zaman said, so a decrease near 35% “is great for patient care.”

At 12 months, 98% of patients in the higher-dose group were medication-free. That matters because “the number one reason for progression is noncompliance with medication or nonadherence,” Zaman said.

All eyes achieved best-corrected distance visual acuity of 20/32 or better, with no serious adverse events or secondary surgical interventions. Endothelial cell loss “was on par with routine cataract surgery,” Zaman said.

The key open question is how long the effect lasts. Zaman said the goal is “at least 3 years of treatment with one procedure,” and that the data so far look promising.

He said any patient who needs cataract surgery and is taking a glaucoma medication such as a prostaglandin analogue could be a candidate. Because the BIM-IOL sits in the capsular bag rather than the angle, “this is an angle-sparing procedure,” preserving options for future glaucoma surgery.

Reference

Zaman F. Interim 12-month safety and efficacy results from a phase 1/2 clinical trial. Presented at: AAO 2026 Annual Meeting; October 9-12, 2026; New Orleans, LA.