A Comparison of 0.1% Timolol Eye Gel and 0.5% Timolol Eye Drop in Patients with Chronic Angle-Closure Glaucoma
Ankana Metheetrairut MD*, Panitee Leumsamran MD*, Supamas Rojananin MD*, Naris Kitnarong MD, MBA*
Affiliation : *Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background : Primary angle-closure glaucoma has been reported with higher prevalence in Asian populations. There is no
significant data of different response of topical medication between angle- closure and open angle eyes.
Objective : The present study investigates ocular hypotensive effect and systemic side effects of 0.1% timolol eye gel once daily
compared with 0.5% timolol eye drop twice daily in patients with chronic angle-closure glaucoma.
Material and Method: The present study was a prospective, randomized, investigator-masked, two-period crossover study
in chronic angle-closure glaucoma patients with each drug tested for a six-week period.
Results : Twenty five eyes were included. Timolol 0.1% eye gel and 0.5% timolol eye drop significantly reduced IOP at 9 am,
11 am and 3 pm compared with baseline (p < 0.001). At week 6, the mean IOP reduction from baseline of 0.5% timolol eye
drop group was higher than that of 0.1% timolol eye gel group at 9 am (3.68 mmHg, 2.51 mmHg respectively) and at 11 am
(4.21 mmHg, 2.51 mmHg respectively). These differences were not statistically significant (p = 0.421, p = 0.157 respectively).
At 3 pm of week 6, the mean IOP change from baseline of 0.1% timolol eye gel group (3.03 mmHg) was more than that of
0.5% timolol eye drop group (2.84 mmHg). There was also statistically insignificant difference (p = 0.873). The highest IOP
reduction of 0.5% timolol eye drop was 4.21 mmHg (19.82%) at 11 am of week 6 and that of 0.1% timolol eye gel was 3.03
mmHg (14.38%) at 3 pm of the same week. There was no significant ocular side effect. Systolic blood pressure after treatment
with 0.1% timolol eye gel and diastolic blood pressure after treatment with 0.5% timolol eye drop were significantly decreased
from baseline (p = 0.006 and p = 0.026 respectively). But there was no clinical significance.
Conclusion : Timolol 0.5% eye drop and 0.1% timolol eye gel effectively reduced IOP in chronic angle-closure glaucoma
patients. There was no statistically significant difference in the ocular hypotensive effect of both drugs over a 24-hour period.
There was no ocular side effect. Systemic side effect was clinically insignificant difference in both groups.
Keywords : Timolol eye drop, Timolol eye gel, Chronic angle-closure glaucoma
