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Twenty-four hour intraocular pressure control with bimatoprost and bimatoprost/timolol fixed combination administered in the morning, or evening in exfoliative glaucoma
  1. Anastasios G P Konstas1,*,
  2. Gabor Hollo2,
  3. Dimitrios Mikropoulos1,
  4. Sevasti Tsironi1,
  5. Anna-Bettina Haidich1,
  6. Theodoros Embeslidis1,
  7. Irene N Georgiadou3,
  8. Murat Irkec4,
  9. Shlomo Melamed5
  1. 1 Aristotle University, Hungary;
  2. 2 Semmelweis University, Greece;
  3. 3 Glaucoma Unit, 1st University Department of Ophthalmology, AHEPA Hospital, Thessaloniki, Greece;
  4. 4 Hacettepe University, Ankara, Greece;
  5. 5 Glaucoma Center, Tel-Hashomer, Greece
  1. Correspondence to: Anastasios G.P. Konstas, University Dept of Ophthalmology, Aristotle University, University Dept of Ophthalmology, AHEPA Hospital, 1 S. Kyriakidi Str., Thessaloniki, 546 36, Greece; konstas{at}


Aim: To compare 24-hour IOP control of morning and evening administered bimatoprost/timolol fixed combination (BTFC) and evening administered bimatoprost in exfoliative glaucoma (XFG).

Methods: One eye of 60 XFG patients was included in this prospective, observer-masked, crossover comparison. Following wash-out all patients received bimatoprost monotherapy for 6 weeks. They were then randomized to morning, or evening administered BTFC for 3 months and then switched to the opposite therapy.

Results: At baseline, mean 24-hour pressure was 29.0 mmHg. Bimatoprost reduced the mean IOP by 8.1 mmHg (27.8%, p<0.001). The evening administration of BTFC reduced 24-hour IOP to a statistically lower level than morning administration (10.2 mmHg (35.3%) vs. 9.8 mmHg (33.8%); p=0.005). Both dosing regimens reduced IOP significantly more than bimatoprost (p¡Ü0.006, for all time points). A 24-hour IOP reduction ¡Ý30% was seen in 43 patients (72%) with evening BTFC compared with 39 patients (65%) with morning BTFC (p=0.344) and only 24 patients (40%) with bimatoprost monotherapy (p<0.001 vs both BTFC regimens).

Conclusion: Both BTFC dosing regimens significantly reduce 24-hour IOP in XFG compared with bimatoprost monotherapy. The evening dosing gives rise to statistically better 24-hour IOP control and could be considered in these patients.

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