Purpose: This article compares 2% dorzolamide (given twice daily) and 2% pilocarpine (given four times a day) for quality of life and preference in patients concurrently receiving 0.5% timolol (given twice daily) for elevated intraocular pressure (IOP).
Methods: This was a 4 week, randomized, two-period crossover study, involving 92 patients with elevated intraocular pressures suitable for adjunctive therapy. The Comparison of Ophthalmic Medications for Quality of Life questionaire was used to assess patient preference and self-reported quality of life. IOP measurements were obtained 2 h after drop instillation at the end of each crossover period.
Results: Overall, patients reported less interference in self-reported quality of life while receiving dorzolamide than while receiving pilocarpine, particularly with regard to limitations in their ability to drive, read, and perform moderate activities; and the bothersomeness of ocular side effects (p < 0.05). In addition, patients reported missing fewer doses of medication when receiving dorzolamide rather than pilocarpine. There was no difference in bothersomeness of bitter/unusual taste between the treatment groups despite a greater frequency reported by patients while receiving dorzolamide. In this study, dorzolamide and pilocarpine were equally effective in lowering intraocular pressure. There was no difference between the two treatments in the clinical examinations of patients throughout the study. However, patients experienced a significant worsening of mean defect of automated visual field examinations when receiving pilocarpine.
Conclusion: At the end of the study, patients preferred dorzolamide to pilocarpine by a ratio of >7:1. Dorzolamide demonstrated less interference in self-reported quality of life than pilocarpine when compared as adjuctive therapy to timolol in the treatment of open-angle glaucoma.