Long-term evaluation of timolol.

Maintenance effect of the topical beta-blocker timolol on intraocular pressure (IOP) was investigated for a mean follow-up of 31.6 months in a group of 155 patients (275 eyes) with glaucoma or ocular hypertension. The mean IOP-value was calculated from 3 readings of the daytime IOP curve, and the mean eye pressure of the right and left eye in the respective individual was used. The medical therapy was carried out with our ranking order of drugs of choice: timolol, timolol combined with adjunctive drug therapy, laser trabeculoplasty and/or filtering surgery. Intraocular pressure was controlled with timolol alone in 98 of 155 patients (63.2%, Group 1). In 36 patients, timolol plus adjunctive medication was required to control IOP (23.2%, Group 2). Twenty-one (13.6%, Group 3) required either laser trabeculoplasty or filtering surgery in addition to timolol. Sufficient IOP-lowering effect was more frequently maintained in patients with ocular hypertension than those with glaucoma simplex or capsular glaucoma. Failures in timolol treatment occurred mostly within 6 months from the start of the therapy and correlated well with higher initial IOP. Transient adverse effects were observed in 11.2% of cases. In three cases (1.9%) local and systemic side effects were serious enough to require discontinuation of the drug therapy. One patient (0.7%) was a non-responder and was withdrawn from the study for that reason. Sixteen patients (10.3%) were lost to follow-up during the 4 year study.