Published in Ophthalmology and Therapy on June 3, 2026, the study reviewed early real-world outcomes from 107 treated eyes. After three months, researchers found lower average eye pressure, fewer topical glaucoma medications, and a substantial increase in the percentage of eyes no longer using pressure-lowering drops.
The findings are encouraging, but they do not mean every glaucoma patient can or should stop using medication. Instead, the research adds to a growing conversation about personalized, interventional glaucoma care and how specialists may combine treatments that work in different ways.
Read the complete peer-reviewed study.
Why Glaucoma Treatment Often Requires More Than One Tool
Glaucoma damages the optic nerve, which carries visual information from the eye to the brain. Many forms of glaucoma progress slowly and without obvious early symptoms. Once glaucoma causes vision loss, doctors cannot restore that lost vision.
The main goal of glaucoma treatment is to lower intraocular pressure (eye pressure) and reduce the risk of further optic nerve damage.
Traditional treatment often begins with prescription eye drops. These medications can work well, but daily use may become difficult over time. Patients may forget doses, struggle to place the drops correctly, experience irritation, or manage several bottles with different schedules.
Glaucoma is also a lifelong condition. A treatment plan that works today may need to change as the disease, eye pressure, medication tolerance, or patient needs change.
That is why modern glaucoma treatment may include several options, such as:
- Prescription eye drops
- Selective laser trabeculoplasty
- Sustained-release medication implants
- Microinvasive glaucoma surgery
- Traditional glaucoma surgery
- Cataract surgery combined with glaucoma treatment
The best plan depends on the type and severity of glaucoma, the condition of the optic nerve, the target eye pressure, previous treatment, and the patient’s overall eye health.
What Did The New Glaucoma Study Examine?
Dr. Funke and co-author Chloe CoHan reviewed outcomes in 107 eyes from 75 adults with open-angle glaucoma.
Each eye received the iDose®TR travoprost implant together with one of two microinvasive glaucoma procedures:
- iStent infinite implantation
- Canaloplasty
Some patients received the glaucoma treatments during cataract surgery. Others received the glaucoma treatments without cataract surgery.
Researchers compared intraocular pressure and use of topical glaucoma medications before treatment and at three months afterward. They also reviewed outcomes by type of glaucoma procedure and whether cataract surgery was performed at the same time.
The study was designed to evaluate a multimodal approach. In plain language, that means using more than one treatment method to address eye pressure through different mechanisms.
What is iDose®TR?
iDose®TR is a small implant placed inside the eye. It continuously releases travoprost, a prescription medication that helps lower eye pressure.
The United States Food and Drug Administration has approved iDose®TR for reducing eye pressure in patients with open-angle glaucoma or ocular hypertension.
Unlike topical eye drops, the implant delivers medication from inside the eye. This removes the need for the patient to remember and administer that particular medication every day.
However, iDose®TR does not guarantee that a patient will become completely free from glaucoma drops. Some patients may still need additional medication, laser treatment, surgery, or another therapy to reach their target pressure.
What Is MIGS?
The two MIGS approaches examined in this study were iStent Infinite and canaloplasty.
iStent Infinite
The iStent Infinite system uses tiny stents placed in the eye’s drainage pathway. The goal is to help fluid move through the trabecular meshwork and Schlemm’s canal more efficiently.
Canaloplasty
Canaloplasty uses a small catheter to access and expand Schlemm’s canal, part of the eye’s natural drainage system. Improving this pathway may help fluid leave the eye more effectively.
Both procedures address fluid drainage. iDose TR® lowers pressure by delivering medication into the eye. Combining the treatments allows the doctor to address eye pressure through multiple pathways. 
What Were The Main Study Results?
The researchers reported several notable changes three months after treatment.
Average Eye Pressure Decreased
Across all 107 treated eyes, average eye pressure decreased from 19.0 mmHg before treatment to 15.3 mmHg after three months.
The study also reported significant average pressure reductions in the larger groups of eyes treated with and without concurrent cataract surgery.
Average Medication Use Decreased
Before treatment, patients used an average of 1.64 topical eye-pressure medications.
After three months, that average decreased to 0.58 medications.
This does not mean every patient stopped every drop. It means the overall number of topical pressure-lowering medications fell across the study group.
More Eyes Were Medication-Free At Three Months
Before treatment, 6.5% of the studied eyes were not using topical pressure-lowering medication.
At the three-month follow-up, 59.4% were medication-free.
Among eyes treated during cataract surgery, 67.7% were medication-free after three months. Among eyes treated without cataract surgery, 46.3% were medication-free.
These percentages describe the patients included in this particular study. They do not predict an individual patient’s outcome. 
What Do These Results Mean For Patients?
The findings suggest that iDose®TR and MIGS may help selected patients lower eye pressure while reducing the burden of topical glaucoma medication.
That could matter for patients who:
- Have difficulty remembering daily drops
- Struggle to place drops correctly
- Experience irritation or other medication side effects
- Use several pressure-lowering medications
- Need steadier medication delivery
- Have glaucoma and cataracts
- May benefit from a combined treatment plan
Reducing the number of daily drops may also make a treatment routine easier to manage. However, convenience is not the only goal. The treatment must also lower pressure enough to protect the optic nerve.
A patient who becomes medication-free still needs regular eye-pressure checks, optic nerve imaging, visual field testing, and long-term glaucoma care.
Glaucoma does not clock out because the bottles leave the bathroom cabinet.
Why Combine iDose®TR With MIGS?
Glaucoma treatment often works best when doctors match several strategies to the needs of one eye.
iDose®TR delivers pressure-lowering medication internally. MIGS procedures help improve fluid drainage. Because they work differently, the treatments may provide complementary pressure control.
Think of it as addressing a traffic problem from two directions. One treatment changes how pressure-lowering medication reaches the eye. The other helps create a clearer route for fluid to leave.
This approach may be especially useful when a patient needs more control than a single treatment can provide.
“Glaucoma is a lifelong disease, and many patients need more than one tool to control eye pressure over time. Our early real-world findings suggest that combining treatments that work in different ways may help appropriately selected patients lower eye pressure while reducing their reliance on daily drops. These results are encouraging, and continued follow-up will help us better understand the long-term role of this approach.” – Christine Funke, MD
Can These Treatments Be Combined With Cataract Surgery?
Yes, some glaucoma procedures can be performed during cataract surgery in appropriate patients.
In this study, 66 of the 107 eyes received cataract surgery together with iDose®TR and either iStent Infinite or canaloplasty. The remaining 41 eyes received the glaucoma procedures without cataract surgery.
Combining procedures may allow a patient to address a visually significant cataract and eye pressure during the same surgical session. However, cataract surgery itself can sometimes lower eye pressure, which makes careful interpretation of combined-treatment research important.
The decision depends on the patient’s cataracts, glaucoma severity, drainage anatomy, pressure target, medication use, and overall health.
What Did The Study Find About Safety?
The researchers reported one intraoperative adverse event. An endothelial detachment occurred during canaloplasty and was repaired in situ. The report states that no additional surgery or lasting complications resulted from that event.
The researchers reported no postoperative adverse events during the three-month follow-up period.
These early findings are reassuring, but every eye procedure carries potential risks. Risks vary by treatment and may include inflammation, bleeding, infection, pressure that becomes too serious or too low, corneal problems, or the need for additional treatment.
A glaucoma specialist should explain the expected benefits, alternatives, and risks before recommending a procedure.
What Are The Study’s Limitations?
The study provides useful early real-world data, but it does not answer every question about iDose®TR and MIGS.
Important limitations include:
- The study reviewed existing medical records rather than randomly assigning treatments.
- All procedures came from one surgeon’s clinical experience.
- The study included 107 eyes, limiting the strength of subgroup comparisons.
- Follow-up lasted only three months.
- The study did not directly compare the combined approach with iDose TR® alone, MIGS alone, or another control group.
- Visual acuity and visual field information were not available at consistent time points for every patient.
- The study did not establish that one combined treatment was superior to another.
One smaller subgroup, comprising 22 eyes treated with iDose TR® and canaloplasty without cataract surgery, showed a significant reduction in medication use but did not achieve a statistically significant reduction in mean intraocular pressure.
Longer and larger studies will help clarify how durable the results are and which patients benefit most.
Who May Be A Candidate for iDose®TR and MIGS?
Not every patient with glaucoma is a candidate for iDose®TR, MIGS, or a combined procedure.
A glaucoma specialist may consider:
- The type of glaucoma
- Current eye pressure
- Target eye pressure
- Optic nerve damage
- Visual field changes
- Drainage-angle anatomy
- Current medications
- Previous laser or surgical treatment
- Cataract symptoms
- Corneal health
- General health and medical history
Patients should never stop taking prescription glaucoma drops without their eye doctor’s instructions. Even after a procedure, some people need one or more medications to keep pressure within a safer range.
Dr. Christine Funke’s Role In The Research
Dr. Christine Funke conceived and designed the study, performed the procedures, supervised the research, and contributed to the manuscript.
She is a board-certified ophthalmologist and fellowship-trained glaucoma specialist at Barnet Dulaney Perkins Eye Center. Her clinical work includes MIGS, drug-eluting glaucoma devices, tube shunts, cataract surgery, and combined cataract and glaucoma procedures.
Dr. Funke provides care at Barnet Dulaney Perkins Eye Center locations in Chandler, Mesa, and Sun City. Patients can learn more about Dr. Christine Funke and her approach to glaucoma care.
What This Research Could Mean For Glaucoma Care
The study adds early evidence supporting a move away from treating glaucoma as a one-tool disease.
Some patients do well with eye drops alone. Others may benefit from laser treatment, a medication implant, MIGS, traditional surgery, or a combination of approaches.
iDose®TR and MIGS may offer glaucoma specialists another way to tailor treatment to the patient rather than forcing every patient into the same daily routine.
The early results are promising. They also reinforce an important point: glaucoma treatment is personal. A percentage in a study cannot replace a complete eye examination, diagnostic testing, and a conversation about your individual pressure goal.
Ask About Your Glaucoma Treatment Options
Glaucoma can progress without pain or noticeable early warning signs. Regular monitoring and timely treatment can help protect the vision you still have.
Barnet Dulaney Perkins Eye Center provides glaucoma testing and advanced treatment options across Arizona, including care from fellowship-trained glaucoma specialists in the Phoenix Metro area and communities throughout the state.
Schedule a glaucoma evaluation at Barnet Dulaney Perkins Eye Center today to learn which treatment options may fit your eyes, your health, and your long-term vision needs.
Study Disclosure
**The study received no external research funding. Glaukos funded editorial assistance, the publication fee, and the journal’s Rapid Service fee. Dr. Christine Funke reports consulting and speaking relationships with Glaukos. Complete author disclosures are available in the published study.