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Abstract #26530 Published in IGR 12-3
Lowering of IOP by echothiophate iodide in pseudophakic eyes with glaucoma
Schmidt KG; Horowitz Y; Buckman G; Segev E; Levinger E; Geyer OCurrent Eye Research 2010; 35: 698-702
Purpose: We retrospectively investigated the intraocular pressure (IOP)-lowering effects of echothiophate iodide (EI) as adjunctive treatment for pseudophakic glaucoma patients who were receiving maximal medical therapy (MMT), including the newer class of medications, i.e., prostaglandin analogs, alpha-2 agonists, and topical carbonic anhydrase inhibitors. Methods: The medical records of all pseudophakic glaucoma patients (24 eyes) under MMT who received supplementary EI 0.125% between January 2002 and December 2003 were reviewed. IOP data and number of medications before, during and after EI treatment were collected. Results: Adding EI to MMT further reduced IOP in 23 of 24 eyes. Three eyes (12.5%) showed some lowering of IOP, but not enough to be considered controlled (IOP above the target pressure). The mean baseline IOP of 30.4(plus or minus)8.2 mmHg (median 29 mmHg) dropped at final follow-up (11.2(plus or minus)3.9 months) to 16.6(plus or minus)4.2 mmHg (median 17 mmHg, p<0.0001) in all eyes that had showed effective pressure reduction upon the addition of EI. Their IOP rose to 27.7(plus or minus)8.0 mmHg (median 28 mmHg, p<0.001) when EI was discontinued because of commercial non-availability. IOP reduction was (greater-than or equal to)20% in 18 (75%) eyes and (greater-than or equal to)30% (a mean decrease of 16.7(plus or minus)8.3mmHg) in 15 eyes (63%). Four eyes (16.6%) required a trabeculectomy despite EI supplement. Five eyes were re-challenged with EI when a small amount was released for sale: their IOP of 26.6(plus or minus)7.1 mmHg after the first EI discontinuation had dropped to 16.4(plus or minus)4.3 mmHg (p<0.0001) and rose to 29.6(plus or minus)7.1 mmHg when EI was again discontinued. The recorded EI-associated side effects were increased miosis in all eyes and headache (8/24 patients), neither of which were reasons for discontinuation of the drug in any patient. Conclusion: EI substantially decreased the IOPs in pseudophakic glaucoma eyes receiving maximal medical therapy, including the newer class of medications. This drug may be the last resort for post-cataract advanced glaucoma patients and may obviate the need for filtering surgery among the very elderly.
O. Geyer. Department of Ophthalmology, Carmel Medical Center, 7 Michal Street, Haifa 34362, Israel. drgo@netvision.net.il
Classification:
9.4.11.2 Glaucomas in aphakia and pseudophakia (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.11 Glaucomas following intraocular surgery)
11.20 Other (Part of: 11 Medical treatment)
