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Addition of dipivefrin for users of pilocarpine and timolol maleate

SUMMARY

Purpose:

To determine the hypotensive effect of dipivefrin hydrochloride 0.1% to eyes previously using pilocarpine 2% and timolol maleate 0.5%.

Methods:

In a prospective study, 26 patients with primary open angle glaucoma using pilocarpine 2% four times daily and timolol maleate 0.5% twice daily underwent 5 lOP measurements at 8 and 10 am and 12, 2 and 4pm. Two weeks after the introduction of dipivefrin twice daily in one eye, new measurements of lOP were made at the same intervals.

Results:

Following the addition of dipivefrin we noticed a significant decrease in the mean lOP (all intervals) (1.49 ± 2.36 mmHg, p = 0.003). There was no statistically significant difference regarding the variability, the lOP spikes and the number of patients with lOP higher than 21 mmHg before and after treatment with dipivefrin. Only 8 patients showed lOP reduction more than 15%.

Conclusions:

In spite of the statistically significant lOP reduction, the additional effect of dipivefrin in patients using pilocarpine and timolol maleate is clinically relevant in only one third of the patients.

Keywords:
Dipivefrin; Primary open angle glaucoma; Timolol maleate; Pilocarpine

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