I addition of a third or fourth antiglaucoma medication effective?

Thi wa a retropective, nonrandomized, noncomparative, interventional tudy including all patient een by a ingle glaucoma pecialit between January 1, 2000 and December 31, 2000 who had a third or fourth antiglaucoma medication added to their exiting regimen of two or three antiglaucoma medication, repectively. Addition of a third or fourth antiglaucoma medication produced a clinically ignificant reduction in IOPin about 40 to 60% of patient at any ingle time point. By Kaplan-Meier analyi the cumulative probability of achieving “efficacy ucce” (≥20% IOP decreae from baeline) wa 33% at 6 month and 23% at 1 year after adding a third medication, and 43% at 6 month and 18% at one year after adding a fourth medication. Combining both efficacy and afety (need for urgical intervention and/or the occurrence of intolerable ide effect to the antiglaucoma medication leading to dicontinuation) decreaed the cumulative probability of ucce to 27% and 14% for the addition of a third medication and 31% and 14% for addition of a fourth medication at 6 month and 1 year, repectively. Thi tudy howed that addition of another antiglaucoma medication to a regimen of two or three medication frequently doe not achieve a lating, ignificant fall (≥20%) in IOP.—Michael D. Wagoner