The choice and efficacy of the drugs for traumatic intraocular hypertension and glaucoma
PURPOSE: To evaluate the clinical efficacy of antihypertensive drugs in the treatment of posttraumatic hypertension and glaucoma. METHODS: The retrospective study was carried out in Regional Clinical Hospital N 3 in Chelyabinsk. Posttraumatic eye hypertension was detected in 76 patients: 65 (85.5%) men and 11 (14.5%) women, the average age was 49+12.7 years. Blunt trauma of the eye globe occurred in 55 (72.3%) patients, open globe injuries were registered in 21 (27.7%). Patients were prescribed with eye drops: timolol 0.5%, brinzolamide 1%, fixed combination: brinzolamide 1% + timolol 0.5% and systemic acetazolamide 250 mg orally 2-3 times daily for the course of 3-5 days. The changes of intraocular pressure (IOP) and visual functions were evaluated in assessing the effectiveness of treatment. RESULTS: Baseline IOP level was 25-43 mm Hg. Medical reduction of IOP was achieved in 56% of patients, mostly after the administration of a brinzolamide 1% + timolol 0.5% fixed combination, or when combined with acetazolamide orally (68%). The IOP decreased in 6.07% patients after brinzolamide 1% administration, in 7.67% patients after a fixed combination of brinzolamide 1% with thymolol 0.5% and 16.78% patients after brinzolamide in combination with beta-blockers and systemic carbonic anhydrase inhibitors. In case of insufficient effectiveness of conservative therapy - 39 (51%) patients underwent various surgical procedures. CONCLUSION: IOP increase after an eye globe injury may have a transient nature and may be controlled by conservative therapy or its combination with various types of eye surgery. The most statistically significant decrease of IOP in post-traumatic hypertension and glaucoma can be achieved using a brinzolamide 1% + timolol 0.5% fixed combination simultaneously with systemic carbonic anhydrase inhibitors.