Toumanidou Victoria, Diafas Asterios, Georgiadis Nikolaos, Tsinopoulos Ioannis
2nd Department of Ophthalmology, Papageorgiou Hospital, Aristotle University of Thessaloniki, 56403 Thessaloniki, Greece.
1st Department of Ophthalmology, Ahepa Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece.
J Clin Med. 2023 Apr 26;12(9):3137. doi: 10.3390/jcm12093137.
To investigate the effect of fixed combination versus concomitant unfixed topical glaucoma treatment on patients' adherence and ocular surface health.
This is a 6-month, prospective, parallel-group, observational study in patients with ocular hypertension (OHT), primary open-angle glaucoma (POAG), or exfoliation glaucoma (XFG). A total of 142 patients with similar baseline characteristics were enrolled in this study. Seventy-one patients received a Latanoprost 0.005%/Timolol 0.5% fixed combination in the evening, whereas seventy-one patients received the unfixed treatment with Latanoprost 0.005% in the evening and Timolol 0.5% twice daily. The primary outcome was the adherence rate at baseline, and at the 3- and 6-month follow-up visits. The secondary outcomes included the signs of ocular surface disease (OSD) and intraocular pressure (IOP).
The adherence of patients treated with the fixed combination was higher than the unfixed treatment at the 3-month (78.0% vs. 63.0%, < 0.001) and at the 6-month visits (73.0% vs. 58.5%, < 0.01). The Break-up Time, Schirmer test, and Van Bijsterveld score were worse in the unfixed group at baseline and all subsequent examinations ( < 0.05 for all comparisons). There were no differences in the mean IOP between groups at baseline, 1-, and 3-month visits. IOP appears higher in the unfixed group at 6 months (16.7 vs. 15.0 mmHg, < 0.01).
The patients with ocular hypertension and primary open-angle glaucoma treated with a fixed combination are significantly more adherent and show a healthier ocular surface than those treated with an unfixed combination. The study provides significant evidence of the benefits of fixed combination treatment.
研究固定复方与不固定的局部青光眼联合治疗对患者依从性和眼表健康的影响。
这是一项针对高眼压症（OHT）、原发性开角型青光眼（POAG）或剥脱性青光眼（XFG）患者的为期6个月的前瞻性平行组观察性研究。共有142例基线特征相似的患者纳入本研究。71例患者在晚上接受0.005%拉坦前列素/0.5%噻吗洛尔固定复方治疗，而71例患者在晚上接受0.005%拉坦前列素不固定治疗且噻吗洛尔0.5%每日两次。主要结局是基线时以及3个月和6个月随访时的依从率。次要结局包括眼表疾病（OSD）体征和眼压（IOP）。
在3个月（78.0%对63.0%；P<0.001）和6个月随访时（73.0%对58.5%；P<0.01），接受固定复方治疗的患者依从性高于不固定治疗。在基线及所有后续检查中，不固定治疗组的泪膜破裂时间、泪液分泌试验和范·比斯特费尔德评分均较差（所有比较P<0.05）。在基线、1个月和3个月随访时，两组间平均眼压无差异。在6个月时，不固定治疗组的眼压似乎更高（16.7对15.0 mmHg；P<0.01）。
与接受不固定复方治疗的患者相比，接受固定复方治疗的高眼压症和原发性开角型青光眼患者依从性显著更高，且眼表更健康。该研究为固定复方治疗的益处提供了重要证据。
