Long-term treatment with Pilogel/beta-blocker in glaucoma patients.

In a multicentre clinical trial thirteen patients with primary open angle glaucoma or ocular hypertension were followed during at least six months while selfinstilling Pilogel (once daily) and topical beta-blocker (twice daily). After six months of combination therapy there was an average decrease in intra-ocular pressure (IOP) of 33.6% 9.5 hours after Pilogel administration and an IOP decrease of 23.4% 22.5 hours after Pilogel administration. With topical beta-blocker alone, an average IOP decrease of 15% was measured. Throughout the study we observed in six patients (46.1%) a superficial punctate keratitis which mostly spontaneously cleared. We did not see any serious side-effects after six months of combination therapy.

Efficacy and safety of the combination therapy Pilogel/beta-blocker: interim results.

The interim results of a multicentered clinical trial with the combination therapy therapy Pilogel/topical beta-blocker (twice daily) in patients with primary open angle glaucoma or ocular hypertension are discussed. Six patients were treated with Pilogel and a topical beta-blocker for one month. Four out of six patients responded well to the combination therapy. Most patients experienced some difficulty in applying the gel and their eyelids stuck together on awakening. In two patients a superficial punctate keratitis was observed. We found an average decrease in intra-ocular pressure (IOP) of 22.5% 22.5 hours after Pilogel administration, but there was some tendency towards higher evening values compared to morning values. In view of the appearance of a corneal haze as described by Johnson et al. during long-term treatment, longer follow-up is necessary.

The influence of oxybuprocaine (Novesine) on the intraocular pressure.

Patients with raised intraocular pressure often have lower tension during hospital admissions than on out-patient measurement, even though the therapy is the same. A prospective study on 18 volunteers and 10 glaucoma patients was set up to find out whether oxybuprocaine eyedrops or repeated applanation tonometry could have anything to do with this. The tension was measured at least 3 times a day with the non-contact tonometer (NCT). In the case of the volunteers oxybuprocaine was instilled into the eye 3 times a day for one week. In the case of the patients the tension in one eye was measured with the Goldmann tonometer on several days after the application of oxybuprocaine drops. No reduction in intraocular pressure was found during the observation period, nor was there an obvious difference between the test eyes and the control eyes. In hospital, patients had at 11 o'clock in the morning intraocular pressure which was on the average 2.2 +/- 1.5 mmHg lower than that measured at out-patient checks, in spite of receiving the same therapy.

The Ocuplot semi-automatic visual field screener--technical evaluation and clinical results.

The perimetric concept and the technical construction of the Ocuplot were evaluated. The mechanical and electrical construction of the instrument we tested was poor. The manufacturer claims improvements in newer specimens. We examined 87 eyes of patients and normal subjects with the Ocuplot and learned that the test-strategy is not efficient and yields a high proportion of false positive results. Clinical results of the patient-examinations are presented.

Glaucoma as a problem in intraocular lens implantation.

The literature has been investigated on the prevalence of preexisting and complicating glaucoma in intraocular lens surgery. Few exact data are available. The problem of the management of preexisting primary or postoperative secondary glaucoma in pseudophakia is discussed, in particular the inevitable restrictions the intraocular lens imposes on medical therapy and eventual glaucoma surgery. Preexisting glaucoma should therefore be a relative contraindication to intraocular lens surgery.

Long-term results of Vidian neurectomy.

A number of publications appeared in the sixties claiming success of Vidian neurectomy in patients with chronic vasomotor rhinitis and recurrent polyposis nasi. During the period from October 1970 through February 1975, a total of 27 Vidian neurectomies was performed in 14 patients (seven males and seven females). Two groups of seven patients each were operated on; seven patients with chronic vasomotor rhinitis and seven patients with recurrent polyposis nasi and rhinitis. Symptoms were quantitatively recorded pre- and postoperatively and patients were followed up 15--66 months. The Rotterdam results appear in the long run inferior to those published in the literature.

Experiences with laser trabeculopuncture.

54 eyes with glaucoma simplex and 21 eyes with secondary chronic glaucoma were treated once by laser trabeculopuncture and followed up for at least 1 year. The results in the first group were encouraging, in the second group disappointing. L.T.P. appears to be a technique with which, in the majority of cases of glaucoma simplex, a sustained moderate decrease in pressure can be obtained.