title: The Effects of Fixed Combination of Bimatoprost-Timolol and Travoprost-Timolol on Intraocular Pressure in Patients With Primary Open-Angle Glaucoma or Ocular Hypertension, Previously on Nonfixed Combination of Latanoprost and Timolol.
abstract: OBJECTIVE
  To compare the effects of fixed combination of bimatoprost-timolol and travoprost-timolol on intraocular pressure (IOP) in patients with primary open-angle glaucoma or ocular hypertension.
  
  
  METHODS
  This was a prospective, randomized, observer-masked, crossover parallel comparison trial.
  
  
  METHODS
  Forty-one patients with primary open-angle glaucoma or ocular hypertension on nonfixed combination of latanoprost and timolol with IOP of 21 mm Hg or less were randomized to either bimatoprost-timolol or travoprost-timolol fixed combinations for 8-week treatment period. Intraocular pressure was measured at 8 AM, 12 PM, 4 PM, and 8 PM at the baseline and at the end point. Conjunctiva hyperemia and superficial punctate keratopathy after treatment with each fixed combination therapy were assessed and compared with the baseline. Patients were then switched to the opposite drug without a medication-free period for another 8-week, and diurnal IOP measurement was repeated.
  
  
  RESULTS
  Bimatoprost-timolol fixed combination reduced the baseline mean diurnal IOP statistically significantly from 17.3 mm Hg [95% confidence interval (CI), 16.8-17.7 mm Hg] to 16.4 mm Hg (95% CI, 15.9-17.0 mm Hg) (P = 0.036). Travoprost-timolol fixed combination lowered the mean diurnal IOP to 17.1 mm Hg (95% CI, 16.5-17.7 mm Hg), but it was not significant. Direct comparison between the 2 fixed combinations showed no significant difference. Both fixed combinations had no significant effect on conjunctiva hyperemia. Interestingly, patients on travoprost-timolol fixed combination had significantly less superficial punctuate keratopathy (P = 0.012).
  
  
  CONCLUSIONS
  Both fixed combination of bimatoprost-timolol and travoprost-timolol had no significantly different ocular hypotensive effect. However, bimatoprost-timolol fixed combination produced additional IOP lowering in patients previously treated with nonfixed combination of latanoprost and timolol.
authors.affiliation: From the *Department of Ophthalmology, Kuala Lumpur Hospital; †Department of Community Health, Universiti Kebangsaan Medical Centre, Kuala Lumpur; and ‡Unit of Biostatistics and Research Methodology, School of Medical Science, Universiti Sains Malaysia, Kelantan, Malaysia.
authors.forename: Ming Yueh
authors.initials: MY
authors.lastname: Lee
authors.forename: Niven C S
authors.initials: NC
authors.lastname: Teh
authors.forename: Mohamed
authors.initials: M
authors.lastname: Nur Zulekha
authors.forename: Sandragasu
authors.initials: S
authors.lastname: Thayanithi
authors.forename: Mohd Noor
authors.initials: MN
authors.lastname: Jelinar
authors.forename: A M
authors.initials: AM
authors.lastname: Rizal
authors.forename: Wan
authors.initials: W
authors.lastname: Arfah