SummaryEffective, prolonged and safe drug delivery to the eye in the treatment of ocular disease is a complex issue for clinical management. The approach to date has largely been adaptive: taking existing potent molecules which are active in reducing VEGF action and repurposing in new vehicles. From the point of view of a device, such materials may not be ideally druggable, the period of treatment too short or the true target involve more than one receptor. The dispersion of the dosage form is also an issue. Outside the eye, the drug may be lost by dilution and vascular/lymphatic clearance and inside, formulation debris at the back of the eye is a risk factor and may alter vision. The next generation of systems must address these concerns and utilize every tool at our disposal to improve efficacy. This includes the selection of better molecules, the use of modeling to better predict the disposition in the aged eye and perhaps the adoption of surgical procedures to increase drug flux more reliably. Up to now, we have relied on a singular approach – the drug‐ to solve the problem and now we realize that drug, vehicle and procedure must be integrated.
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