The efficacy and safety of bimatoprost/timolol maleate, latanoprost/timolol maleate, and travoprost/timolol maleate fixed combinations on 24-h IOP.

PURPOSE: To evaluate the effect of bimatoprost/timolol maleate fixed combination (BTFC), latanoprost/timolol maleate fixed combination (LTFC), and travoprost/timolol maleate fixed combination (TTFC) on 24-h intraocular pressure (IOP) in patients with open-angle glaucoma. METHODS: This prospective, observer-masked, randomized study included 50 patients with primary open-angle glaucoma. All patients were using hypotensive lipids and timolol maleate fixed combination treatment for ≥4 weeks and had an IOP ≤ 21 mmHg. Group 1 (n = 18) received BTFC, group 2 (n = 14) received LTFC, and group 3 (n = 18) received TTFC. All patients were hospitalized, and IOP was monitored for 24-h (10:00, 14:00, 18:00, 22:00, 02:00, and 06:00). Mean diurnal IOP variation measurements were taken between 06:00 and 18:00, and mean nocturnal IOP variation measurements were taken between 22:00 and 02:00. Mean IOP and IOP variation in the three groups were compared. RESULTS: Mean 24-h IOP did not differ significantly between the three groups (group 1: 14.6 ± 2.9 mmHg; group 2: 14.1 ± 3.7 mmHg and group 3: 15.8 ± 2.0 mmHg; P > 0.05). Mean diurnal IOP variation was 4.6 ± 2.3 mmHg in group 1, 5.8 ± 2.4 mmHg in group 2, and 4.3 ± 1.7 mmHg in group 3, and mean nocturnal IOP variation was 3.2 ± 2.8 mmHg in group 1, 2.9 ± 1.9 mmHg in group 2, and 3.0 ± 1.6 mmHg group 3. There were not any significant differences in diurnal or nocturnal IOP variation between the three groups (P < 0.05). CONCLUSION: All three fixed combinations effectively controlled IOP for 24-h and had a similar effect on diurnal and nocturnal IOP variations.

Effects of primary selective laser trabeculoplasty on anterior segment parameters.

AIM: To investigate the effects of selective laser trabeculoplasty (SLT) on the main numerical parameters of anterior segment with Pentacam rotating Scheimpflug camera in patients with ocular hypertension (OHT) and primary open angle glaucoma (POAG). METHODS: Pentacam measurements of 45 eyes of 25 (15 females and 10 males) patients (12 with OHT, 13 with POAG) before and after SLT were obtained. Measurements were taken before and 1 and 3mo after SLT. Pentacam parameters were compared between OHT and POAG patients, and age groups (60y and older, and younger than 60y). RESULTS: The mean age of the patients was 57.8±13.9 (range 20-77y). Twelve patients (48%) were younger than 60y, while 13 patients (52%) were 60y and older. Measurements of pre-SLT and post-SLT 1mo were significantly different for the parameters of central corneal thickness (CCT) and anterior chamber volume (ACV) (P<0.05). These parameters returned back to pre-SLT values at post-SLT 3mo. Decrease of ACV at post-SLT 1mo was significantly higher in younger than 60y group than 60y and older group. There was no statistically significant difference in Pentacam parameters between OHT and POAG patients at pre- and post-treatment measurements (P>0.05). CONCLUSION: SLT leads to significant increase in CCT and decrease in ACV at the 1(st) month of the procedure. Effects of SLT on these anterior segment parameters, especially for CCT that interferes IOP measurement, should be considered to ensure accurate clinical interpretation.

Suprachoroidal implant surgery in intractable glaucoma.

PURPOSE: To report the early results of suprachoroidal silicone implant surgery in intractable glaucoma. MATERIALS AND METHODS: A modified silicone implant with no valve was implanted into the suprachoroidal space of 15 eyes with intractable glaucoma. RESULTS: The mean age of the patients was 53.0 ± 24.5 (range 7-85) years, the mean follow-up time was 17.1 ± 4.8 (range 10-28) months, and the mean preoperative intraocular pressure (IOP) of patients receiving two or more medications was 33.1 ± 9.8 mmHg. At the last follow-up visit, mean IOP was 16.5 ± 7.9 (range 10-35) mmHg (Wilcoxon signed rank test, p = 0.001). The functional success, i.e., IOP ≤21 mmHg both with and without antiglaucomatous drugs, was 93.3%. The total success rate, i.e., IOP ≤21 mmHg without medication, was 13.3%. The average number of antiglaucomatous drugs used was 3.8 (range 2-5) preoperatively, and 2.2 postoperatively (range 0-4) (Wilcoxon signed rank test, p = 0.011). There was a ≥30% decrease in the IOP of 66.6% of the eyes. Shallow choroidal detachment as proof of drainage was evident in all cases. CONCLUSION: Drainage of the aqueous humor from the anterior chamber to the suprachoroidal space via implantation of a modified silicone implant is effective in lowering the IOP in intractable glaucoma.