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Twenty-four-hour intraocular pressure control with bimatoprost and the bimatoprost/timolol fixed combination administered in the morning, or evening in exfoliative glaucoma
  1. Anastasios G P Konstas1,
  2. Gábor Holló2,
  3. Dimitrios Mikropoulos1,
  4. Sevasti Tsironi3,
  5. Anna-Bettina Haidich4,
  6. Theodoros Embeslidis1,
  7. Irene Georgiadou1,
  8. Murat Irkec5,
  9. Shlomo Melamed6
  1. 1Glaucoma Unit, 1st University Department of Ophthalmology, AHEPA Hospital, Thessaloniki, Greece
  2. 2Department of Ophthalmology, Semmelweis University, Budapest, Hungary
  3. 3Department of Ophthalmology, Papanikolaou Hospital, Thessaloniki, Greece
  4. 4Department of Hygiene, Aristotle University of Thessaloniki, Thessaloniki, Greece
  5. 5Department of Ophthalmology, Hacettepe University, Ankara, Turkey
  6. 6Sam Rothberg Glaucoma Center, Tel-Hashomer, Israel
  1. Correspondence to Dr Anastasios G P Konstas, Glaucoma Unit, 1st University Department of Ophthalmology, AHEPA Hospital, 1 Kyriakidi Str, Thessaloniki 546 36, Greece; konstas{at}


Aim To compare 24 h intraocular pressure (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 randomised to morning, or evening, administered BTFC for 3 months and then switched to the opposite therapy.

Results At baseline, mean 24 h pressure was 29.0 mm Hg. Bimatoprost reduced the mean IOP by 8.1 mm Hg (27.8%, p<0.001). The evening administration of BTFC reduced 24 h IOP to a statistically lower level than morning administration (10.2 mm Hg (35.3%) vs 9.8 mm Hg (33.8%); p=0.005). Both dosing regimens reduced IOP significantly more than bimatoprost (p≤0.006, for all time points). A 24 h IOP reduction ≥30% 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 h IOP in XFG compared with bimatoprost monotherapy. The evening dosing gives rise to statistically better 24 h IOP control and could be considered in these patients.

  • Exfoliative glaucoma
  • bimatoprost
  • bimatoprost/timolol fixed combination
  • intraocular pressure
  • drugs
  • treatment medical
  • clinical trial

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  • Funding This study was supported in part by an unrestricted grant from Allergan.

  • Competing interests AGPK is a consultant of Allergan, Alcon, Pfizer, MSD; GH is a consultant of Allergan, Alcon, MSD, Pfizer and Santen; MI is a consultant of Allergan; SM is a consultant of Allergan.

  • Ethics approval Ethics approval was provided by the Bioethics Committee of the Medical School of the Aristotle University of Thessaloniki.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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