We evaluated the use of topically administered betaxolol, a cardioselective beta-adrenergic blocking agent, in 11 patients (eight women and three men, 40 to 81 years old) who had asthma and severe glaucoma with increased intraocular pressure despite maximally tolerated medical therapy. In each of these patients, timolol was either contraindicated or had previously led to development of pulmonary symptoms or complications. Before betaxolol, mean forced expiratory volumes in one second were 66% in the men and 80% in the women of reported normal values in age- and height-matched groups. Betaxolol was then topically administered twice daily. All patients continued to administer betaxolol without exacerbation of pulmonary symptoms and without deterioration in measured pulmonary function tests. Betaxolol further reduced intraocular pressure by a mean of 18% (4 mm Hg) when added to the patients' otherwise maximal regimen.

Administration, Topical↗

PubMed1985

Topical indomethacin therapy before argon laser trabeculoplasty.

Fifty treatment sessions for 43 eyes (35 patients) receiving argon laser trabeculoplasty to one-half the angle were randomly assigned in a double-masked fashion to pretreatment with either topical indomethacin 1% or placebo. In 25 treatments intraocular pressure increased 3 mm Hg or more within four hours. Topical indomethacin pretreatment had no effect on the incidence, magnitude, or time course of this acute increase. It also did not alter the long-term effectiveness of the laser treatment (-3.8 mm Hg in the indomethacin-treated group vs -4.3 mm Hg in the placebo-treated group). The overall incidence of new peripheral anterior synechiae found on gonioscopy at one month was 32% (16 of 50 treatments). Synechiae formation was much higher in blacks (ten of 11 eyes or 91%) than in whites (five of 38 eyes or 13%). Although there was an association between acute anterior chamber inflammation after laser treatment and ultimate synechia formation (P less than .05), indomethacin pretreatment did not alter its occurrence.

Aged↗

PubMed1984

Betaxolol and timolol. A comparison of efficacy and side effects.

Betaxolol hydrochloride, 0.5%, and timolol maleate, 0.5%, were compared in a 26-week randomized, double-masked study involving 46 patients with primary open-angle glaucoma. The two drugs were comparable with regard to both intraocular pressure-lowering efficacy and side effects. Since betaxolol is a selective beta 1-adrenergic antagonist, it may be advantageous for patients in whom beta 2-blockade could be harmful.

Aged↗

PubMed1983

Goniotomy vs external trabeculotomy for developmental glaucoma.

We compared external trabeculotomy and goniotomy in similar groups of patients with developmental glaucoma. External trabeculotomy was statistically more successful as a first operation (19 of 23 eyes, 83%) than goniotomy (eight of 24 eyes, 33%) (P = .003). With multiple operations both procedures controlled intraocular pressure in most patients but more operations were required after goniotomy (31 procedures in 12 eyes) than after external trabeculotomy (13 procedures in eight eyes) than after occurred within one year of surgery (six of eight failures with external trabeculotomy and 20 of 23 failures with goniotomy).

Adolescent↗

PubMedDate not supplied

Augmenting the ablative effect of liver electrolysis: using two electrodes and the pringle maneuver.

Several methods of liver tumor ablation have been investigated, and these include the novel technique of electrolysis. Electrolysis is slower than other forms of ablative therapy. This study determined methods of increasing the ablative effect of electrolysis. Domestic white pigs were divided. One group received electrolysis using two electrode catheters, and in the other group a concurrent intermittent Pringle maneuver was performed to induce intermittent ischemia. The effect of two electrode catheters versus a single electrode catheter was compared, and the effect of the Pringle maneuver versus no Pringle was examined with two electrode catheters. The livers were harvested, and the volume of each lesion was calculated. There was a linear relationship between the volume of hepatic necrosis and the electrolytic dose in (p <.005) in both the single-electrode-catheter and two-electrode-catheter groups. Comparison between the single- and multiple-electrode groups showed a highly significant difference in the dose response (p <.0000002) when more than one electrode was used. Use of the Pringle maneuver during electrolysis produced larger volumes of hepatic necrosis over all doses when using two electrode catheters. Rates of necrosis were 3.8 cm(3)/100 C for a single electrode catheter, 5.46 cm(3)/100 C for two electrode catheters without Pringle, and 6.17 cm(3)/100 C for electrolysis with two electrode catheters coupled with intermittent Pringle maneuver. Thus, electrolysis was both reliable and predictable in producing hepatic necrosis in a dose-dependent manner. The time delay in achieving tumor ablation via electrolysis can be overcome by using two electrodes combined with the Pringle maneuver to increase the volume of the lesion produced.

Animals↗