Chemical sympathectomy with 6-hydroxydopamine in the treatment of primary open-angle glaucoma.

Chemical sympathectomy with 6-hydroxydopamine combined with subsequent topical epinephrine therapy was evaluated with regard to intraocular pressure effects in primary open-angle glaucoma. After chemical sympathectomy intraocular pressure was maintained below 20 mm Hg with 1.0% epinephrine three times daily in 29 of 36 eyes of 25 patients for two to 29 weeks. Chemical sympathectomy combined with epinephrine therapy was most effective in patients whose intraocular pressure had been well controlled with pilocarpine and epinephrine and was less effective in patients whose intraocular pressure had not been controllable with maximum medical therapy prior to the administration of 6-hydroxydopamine. The results of this study suggest that chemical sympathectomy combined with topical epinephrine therapy has considerable clinical value in the medical management of primary open-angle glaucoma.