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Study: Timolol gel displays similar efficacy as timolol eye drops
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In evaluating timolol 0.1% gel compared to timolol 0.5% eye drops, researchers found that both treatments were effective after phacoemulsification surgery.
Both the gel and the eye drops were found to reduce IOP and IOP spikes after cataract surgery, as detailed in the European Journal of Ophthalmology study.
Seventy participants who underwent uncomplicated cataract surgery with phacoemulsification and IOL implantation were included, according to the prospective, double-masked, randomized study.
Cagini and colleagues reported that 25 participants received the gel (group A), 20 participants received the eye drops (group B) and 25 participants received no treatment (group C). In each group, IOP was measured before surgery (T0) as well as 5 minutes (T1), 2.5 hours (T2), 4.5 hours (T3) and just over 24 hours (T4) after the surgery.
Results showed that participants who were treated with the gel or the eye drops had lower mean IOP measurements than participants with no treatment at 2.5 hours, 4.5 hours and just over 24 hours after the surgery.
Additionally, higher spikes in IOP were observed in the group with no treatment.
"At T2, they were observed in 40% of the patients in group A, 30% in group B, and 76% in group C; and at T3, in respectively 20%, 10%, and 68%; and at T4, in respectively 4%, 0%, and 28%," the authors reported.
"Timolol 0.1% gel is as effective as timolol 0.5% eye drops in reducing IOP and in limiting the occurrence of IOP spikes for up to 24 hours after phacoemulsification," the authors concluded.
Disclosure: The authors have no relevant financial disclosures.
Perspective
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Carl H. Jacobsen, OD, FAAO
Cataract surgery has an excellent safety profile, but complications still occur, the most common being postoperative intraocular pressure elevation. As a precaution, some surgeons use apraclonidine 1% as a proven, powerful treatment for postop IOP spikes.
Interestingly, Cagini and colleagues have chosen to test two concentrations of timolol (a less potent IOP-lowering agent) in this group of patients. Their finding that a single dose of 0.1% timolol gel is as effective at lowering IOP as a single dose of 0.5% timolol drop is interesting, but it is hard to understand how this finding might affect clinical practice. It is doubtful that timolol would replace apraclonidine as the treatment of choice for postop IOP spikes.
Perhaps this research could lead to investigation of low concentration timolol as a viable treatment for chronic glaucoma. Were 0.1% timolol gel found to be as efficacious as higher concentration timolol with fewer side effects, clinicians might take notice.
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Eur J Ophthalmol. 2014; doi: 10.5301/ejo.5000472.
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