Topical ocular hypotensive medication and lens opacification: evidence from the ocular hypertension treatment study.
OBJECTIVE
To determine whether topical ocular hypotensive medication is associated with refractive changes, visual symptoms, decreased visual function, or increased lens opacification.


METHODS
Multi-center clinical trial.


METHODS
We compared the medication and observation groups of the Ocular Hypertension Treatment Study (OHTS) during 6.3 years of follow-up with regard to the rate of cataract and combined cataract/filtering surgery, and change from baseline in visual function, refraction, and visual symptoms. A one-time assessment of lens opacification was done using the Lens Opacities Classification System III (LOCS III) grading system.


RESULTS
An increased rate of cataract extraction and cataract/filtering surgery was found in the medication group (7.6%) compared with the observation group (5.6%) (hazard ratio [HR] 1.56; 95% confidence interval [CI] 1.05 to 2.29). The medication and observation groups did not differ with regard to changes from baseline to June 2002 in Humphrey visual field mean deviation, Humphrey visual field foveal sensitivity, Early Treatment of Diabetic Retinopathy Study (ETDRS) visual acuity, refraction, and visual symptoms. For the medication and observation groups, LOCS III readings were similar for nuclear color, nuclear opalescence, and cortical opacification. There was a borderline higher mean grade for posterior subcapsular opacity in the medication group (0.43 +/- 0.6 SD) compared with the observation group (0.36 +/- 0.6 SD) (P = .07).


CONCLUSIONS
We noted an increased rate of cataract extraction and cataract/filtering surgery in the medication group as well as a borderline higher grade of posterior subcapsular opacification in the medication group on LOCS III readings. We found no evidence for a general effect of topical ocular hypotensive medication on lens opacification or visual function.
Herman
David C
DC
Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
Gordon
Mae O
MO
Beiser
Julia A
JA
Chylack
Leo T
LT
Lamping
Kathleen A
KA
Schein
Oliver D
OD
Soltau
Joern B
JB
Kass
Michael A
MA
D000287:Administration, Topical; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002386:Cataract / Q000139:chemically induced*; D002387:Cataract Extraction / Q000706:statistics & numerical data; D018463:Filtering Surgery / Q000706:statistics & numerical data; D005500:Follow-Up Studies; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D007908:Lens, Crystalline / Q000187:drug effects*; D008875:Middle Aged; D009798:Ocular Hypertension / Q000188:drug therapy* / Q000601:surgery; D012029:Refraction, Ocular / Q000187:drug effects; D014792:Visual Acuity / Q000187:drug effects
D000959:Antihypertensive Agents