Clobetasone butyrate eye drops. Effect on ocular inflammation and intraocular pressure

Clobetasone butyrate eye drops comprise a new steroid preparation which has been investigated in two comparable, double-blind, multicentre clinical trials in patients with ocular inflammation. One study compared clobetasone butyrate with betamethasone phosphate eye drops (205 patients) and the other study compared corresponding preparations containing neomycin (169 patients). There was no difference between the responses to clobetasone butyrate and betamethasone. An excellent or good response was obtained in 73 per cent of patients treated with clobetasone butyrate, 75 per cent with betamethasone, 69 per cent with clobetasone butyrate formulated with neomycin, and 76 per cent with betamethasone formulated with neomycin. Patients who were known to react with a rise of intraocular pressure (IOP) to steroids were treated with clobetasone butyrate eye drops in one eye and either prednisolone eye drops (6 patients) or hydrocortisone eye drops (4 patients) in the other eye. The doses were continued for 6 weeks, or less if the IOP rose more than 10 mm Hg in one eye. All patients experienced a greater intraocular pressure rise in the eye treated with prednisolone or hydrocortisone. The mean changes in IOP were 9 mm Hg for prednisolone compared to 2 mm Hg for clobetasone butyrate (P less than 0.05 Wilcoxon signed ranks test) and 16 mm Hg for hydrocortisone compared to 2 mm Hg for clobetasone butyrate.