Prin RojanaPongpun,¹ Surinder S Pandav,² Manolito R Reyes,³ Ataya Euswas^4
1Department of Ophthalmology, Chulalongkorn University, Bangkok, Thailand, ²Department of Ophthalmology, Postgraduate Institute of Medical Education and Research, Chandigarh, India, ³Department of Ophthalmology, Far Eastern University Medical Center, Quezon City, The Philippines, and ⁴Department of Ophthalmology Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

Aim: To compare the efficacy, safety, and tolerability of bimatoprost 0.03% once daily with timolol 0.5% twice daily for patients with chronic angle closure glaucoma.
Methods: In this multicentre double-masked randomised comparative trial conducted in Thailand, India, and The Philippines, patients with chronic angle closure glaucoma who had previously undergone laser peripheral iridotomy were treated with bimatoprost (n = 107) or timolol (n = 105) for 3 months. Patients were assessed at baseline, 2 weeks, 6 weeks, and 3 months. The primary outcome measures were the mean percentage change in intraocular pressure from baseline (efficacy) and the number and type of adverse events (safety and tolerability).
Results: The mean total percentage decrease in intraocular pressure was significantly greater for the bimatoprost group than the timolol group at 2 weeks (30.6% vs 19.2%; p < 0.001), 6 weeks (29.7% vs 18.8%; p < 0.001), and 3 months (28.3% vs 18.4%; p < 0.001). The reduction in mean intraocular pressure 3 months from baseline was greater for the bimatoprost group than the timolol group (mean difference,-2.49 mm Hg; 95%confidence interval, -3.79 to -1.19 mm Hg). Conjunctival hyperaemia was the most frequently reported adverse event. There was no significant difference in the number of patients in each treatment group who withdrew because of an adverse event.
Conclusion: Bimatoprost once daily was more effective than timolol for lowering intraocular pressure in patients with chronic angle closure glaucoma. Both bimatoprost and timolol were well tolerated, with few systemic adverse events reported.

Key words: Bimatoprost, Clinical trial, Glaucoma, angle-closure, Timolol

Asian J Ophthalmol. 2007;9:239-244.