Procedural Pharmaceuticals in Glaucoma with Steve Sarkisian, ep 42
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Who is Steve Sarkisian and what brings him onto the show?
Hey, Steve Sarkeesian, founder and CEO of Oklahoma Eye Surgeons. I got that right, right? Oklahoma Eye Surgeon. Yeah. Welcome to the show.
Thanks, Rob. I appreciate the invitation. It's been about over about 15 years or something since I've been on. I'm glad to be on again. I thank you for the invitation to talk.
It's great having you. And also it's sort of a relaunch of the show. It's been a year and a half or so since my last episode, I got carried away with a amateur singing career. And I've always been a rock star wannabe. So that's where the past year and a half have gone.
Man, that's, that's awesome. I'm, I'm jealous. I always had these visions of my children learning how all to play like my, like we can easily have a good, cause I have four, four, we have four children and, um, a couple of them are somewhat musical, but the thought of having a family rock band is kind of, it'll never happen, but it's, it's a, it's a, it's a fun, it's a fun delusion. I, I actually would, that was one of the priorities. I wanted my children to have a firm understanding of rock music. And so every weekend I would be sitting, after getting back from the gym, I'd sit in the hot tub and all the kids would be out there. I just would teach them about different eras of rock music. And it's like, okay, this is punk and this is New Wave and this is ska and this is... And man, they ate it up.
They really enjoyed it. Yeah.
Amazingly. Now let's teach some people about glaucoma.
Now let's teach people some procedural pharmaceuticals. Yeah.
Teach them about that.
What clinical trials did Dr. Sarkisian lead for iDose (travoprost) and Durysta (bimatoprost)?
What have you been involved with? So... The eye dose is the latest, greatest, next big thing.
I've been involved in trials with the eye dose, the traviprost, sustained release, and the bimatoprost, sustained release, the Durista. Right. So there were several Durista studies. that I was involved with, probably actually about three or four of them. And then the original IDOS-TR study, the phase two, and then the phase three studies that allowed us to get FDA approval. I was the largest recruiter in the phase three study. So I was the first author on several of those papers that allowed the pivotal data that got us FDA approval, just talking about both safety and efficacy. And, and of course the story goes on the next generation of eye dose implants are, are, are being, are being studied and I'm part of that.
And, and, and even combining eye dose other things and eye dose and cataract surgery and, um, These are all things that are being looked at.
And there are different delivery methods, right? One type is injecting basically a piece of Vicryl.
The other is injecting a dissolvable... matrix that gets injected into the, the FDA approval technique was in the anterior chamber. Right. And a lot of shift to injecting it in the sulcus if the patient is pseudophagic just for the sake of endothelial protection. And, and I think interestingly when the IDOS came out and there was a gap in coverage, like a lot of, a lot of people increased their volume of Durista because they were like, okay, now when this wears off in six to 12 months, hopefully we'll get reimbursion Fridays. It's now been It's now been almost since February of 2024, we had the first commercially available eye doses and I was among the first to implant them on Valentine's Day. And we now have pretty good coverage for pretty much most of the Macs and
But even a lot of the Medicare Advantage plans are starting to pay for it. Now, we still have to fight. I have the dubious distinction of being the first surgeon to submit an eye dose to Medicare for reimbursement. And now the eye dose, differing from the Darista, Darista being in, it can be done anywhere. It can be done in the ASC. Or it can be done in the office.
How are iDose implants delivered – anterior chamber vs. sulcus injection?
I think 99% of everyone does them in the office just for expediency. And invariably, the patient says the following words after a turista is implanted. Is that it? That's usually what they say. They say, is that it? Especially those who have had rattle injections because they're freaked out by the thought of that.
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Chapters
8 chapters
1
Who is Steve Sarkisian and what brings him onto the show?
0:01–1:39
2
What clinical trials did Dr. Sarkisian lead for iDose (travoprost) and Durysta (bimatoprost)?
1:39–4:35
3
How are iDose implants delivered – anterior chamber vs. sulcus injection?
4:35–6:49
4
What challenges exist with Medicare reimbursement for iDose and how were they overcome?
6:49–8:48
5
Why does Dr. Sarkisian use SLT as his first‑line therapy for glaucoma?
8:48–12:12
6
How does combining iDose with MIGS or cataract surgery improve outcomes?
12:12–15:44
7
What does the long‑term data show about repeatable iDose implants and durability?
15:44–18:41
8
What future procedural‑pharmaceutical technologies (e.g., SpyGlass lens, AlloFlo Uveo) are on the horizon?
18:41–23:30