Eyeworld

EW INTERNATIONAL 114 September 2017 Editors' note: Dr. Cetinkaya has no financial interests related to his com- ments. Contact information Cetinkaya: Drservet42@gmail.com site of action is local within the eye. It decreases aqueous humor produc- tion thus leading to a decrease in IOP. In this study, the IOP-lowering effect of dorzolamide was enhanced by its combination with timolol maleate, a beta blocker." In the current study, the effi- cacy of combination therapy using dorzolamide-timolol maleate did not differ from that of oral acetazol- amide. Previous studies, however, that used topical CAIs such as dor- zolamide and brinzolamide after cat- aract surgery found various degrees of efficacy compared to systemic acetazolamide. In one such study, 1 a fixed combination of dorzolamide- timolol was effective in reducing IOP in 76 eyes of 38 patients for up to 24 hours after cataract surgery. The patients received one drop of the fixed drug combination in one eye immediately after surgery. This treatment regimen did not, however, prevent OVD-induced IOP spikes of 30 mm Hg or higher, which were seen in both the combination drug patients and control patients alike. In a different study 2 that investigat- ed the effects of oculopression with and without dorzolamide in the eye, it was shown that IOP reduction by purely mechanical means like oculo- pression led to a significant increase of flow velocities of the retrobulbar vessels in 60 cataract patients. This effect could be significantly in- creased by using dorzolamide prior to oculopression. "For the prophylaxis of a post- operative IOP rise after an unevent- ful cataract surgery, the combination of topical dorzolamide-timolol ma- leate has the same effect in lowering IOP as oral acetazolamide therapy," Dr. Cetinkaya said. "However, the adverse effects of systemic acetazol- amide should be taken into account, suggesting that it therefore might be better to choose topical dorzol- amide-timolol maleate combination therapy." EW References 1. Rainer G, et el. Effect of a fixed dorzol- amide-timolol combination on intraocular pressure after small-incision cataract surgery with Viscoat. J Cataract Refract Surg. 2003;29:1748–52. 2. Huber-van der Velden KK, et al. Retrobulbar hemodynamics before and after oculopression with and without dorzolamide. Curr Eye Res. 2012;37:719–25. Keeping continued from page 112 Characteristics, outcomes Group 1, n=33 (oral acetazolamide) mean, percentage, range Group 2, n=34 (Topical dorzolamide-timolol maleate combination) mean, percentage, range P value Age (years) 62.96 ± 11.58 (SD) (46–83) 62.88 ± 9.38 (SD) (43–81) 0.733 Sex Male 17 (51%) 16 (47%) 0.720 Female 16 (49%) 18 (53%) Preoperative BCVA (logMAR) 0.83 ± 0.21 (SD) (0.30–1.00) 0.78 ± 0.24 (SD) (0.4–1.00) 0.312 Postoperative BCVA (logMAR) 0.10 ± 0.11 (SD) (0.00–0.30) 0.07 ± 0.11 (SD) (0.00–0.30) 0.411 Preoperative IOP (mm Hg) 14.60 ± 3.21 (SD) (10–21) 14.67 ± 2.77 (SD) (11–21) 0.924 Postoperative IOP (first day) (mm Hg) 15.27 ± 2.90 (SD) (11–23) 14.82 ± 2.57 (SD) (11–23) 0.505 Postoperative IOP (first week) (mm Hg) 13.72 ± 2.44 (SD) (10–18) 13.64 ± 2.53 (SD) (10–19) 0.895 Characteristics and outcomes of group l and group 2 patients Source: Servet Cetinkaya, MD CORNEA and EYE BANKING NEW ORLEANS FRIDAY, NOVEMBER 10 FORUM 2017 FallSymposium.CorneaSociety.org

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