A comparison of the ocular hypotensive efficacy of twice-daily 0.25% levobunolol to 0.5% timolol in patients previously treated with 0.5% timolol.

Treatment with noncardioselective beta-adrenoceptor antagonists (e.g., 0.5% timolol or 0.5% levobunolol) is standard practice for lowering elevated intraocular pressure (IOP). However, because there are risks and side effects associated with the use of these agents, a lower, yet still effective, dose may be preferred. We gave 0.5% timolol twice daily for 30 days to 143 patients. In a double-masked, randomized fashion, we then assigned patients to continue to receive 0.5% timolol twice daily or 0.25% levobunolol twice daily for 8 weeks. The mean unmedicated baseline IOP for both groups was approximately 25 mm Hg. After 30 days of timolol pretreatment, the mean IOP in both groups decreased to approximately 19 mm Hg (p = 0.210). After the 30-day timolol pretreatment period, and subsequent randomization to either 0.5% timolol or 0.25% levobunolol treatment, there was little change in overall mean IOP (0.03 mm Hg decrease for levobunolol, 0.06 mm Hg increase for timolol; p = 0.811) from the timolol pretreatment baseline. One patient assigned to the timolol treatment group was terminated from the study due to inadequate control of IOP. We conclude that the mean IOP lowering effect of 0.25% levobunolol is equivalent to 0.5% timolol, and switching patients from twice-daily 0.5% timolol to twice-daily 0.25% levobunolol poses no significant risk of decreased ocular hypotensive efficacy.

Prolapse of a rigid anterior chamber lens through an iridectomy: report of ten cases.

I have observed ten cases in which a rigid anterior chamber lens prolapsed through the iridectomy. The lens dislocation was associated with cystoid macular edema in four cases and threatened the cornea in two cases. Vitrectomy and replacement with a flexible lens resulted in good vision. Removing the prolapsed lens haptic proved to be easy. Visual prognosis is good.

A review of 100 cases of flexible anterior chamber lens implantation.

We report the results of 100 cases of flexible anterior chamber lens (Stableflex) implantation following intracapsular cataract extraction. Follow-up ranged from 12 to 22 months. Ninety-six percent of patients attained a visual acuity of 20/40 or better. The complication rate was low.