The intraocular pressure lowering effect of timolol in gel-forming solution

The effect on the intraocular pressure (IOP) of 0.5% timolol solution given twice daily was compared to 0.5% timolol in gel-forming solution given once daily. Patients (n = 223) having an IOP of above 22 mmHg were recruited from 16 eye specialist centres in Scandinavia and Finland. The patients were randomized to two treatment groups, timolol solution treatment and timolol in gel-forming solution treatment. Eyes with and without pseudoexfoliation were included. The patients were stratified regarding the presence or not of pseudoexfoliation, to ensure appropriate distribution of this condition. No difference in intraocular pressure reducing effect was registered for the two groups. The pressure reducing effect of the two modes of treatment was not affected by the presence or not of pseudoexfoliation. The study also included registration of local and systemic signs and symptoms possibly related to the study medications. Blurring of vision occurred more often in patients given 0.5% timolol in gel-forming solution compared to timolol solution. The heart rate decreased statistically significantly in patients given timolol solution, but not in patients given timolol in gel-forming solution. This study suggests that treatment with 0.5% timolol in gel-forming solution once a day may be equally as good as 0.5% timolol solution given twice a day in patients with glaucoma both with and without pseudoexfoliation.