Comparison of dorzolamide/timolol vs brinzolamide/brimonidine fixed combination therapy in the management of primary open-angle glaucoma

Purpose: To compare the efficiency of brinzolamide/brimonidine fixed combination vs the dorzolamide/timolol fixed combination. Methods: Forty-four eyes of 44 patients were divided in 2 groups treated either with dorzolamide/timolol twice a day (group A) or with brinzolamide/brimonidine twice a day (group B). Complete ophthalmic examination including Goldmann applanation tonometry was performed before treatment administration and 1, 4, 8, and 12 weeks afterwards. The intraocular pressure (IOP) was measured twice a day (morning at 9 AM and afternoon at 4 PM). Results: At the end of the follow-up period (12 weeks), mean morning IOP reduction was 7.0 +/- 2.8 mm Hg in group A and 8.4 +/- 1.9 mm Hg in group B. A significant difference was found (p = 0.0343). In contrast, mean afternoon IOP reduction was 8.6 +/- 2.7 mm Hg in group A and 7.9 +/- 1.6 mm Hg in group B and no significant difference was found (p = 0.3413). No significant adverse effects were observed in either group. Conclusions: Brinzolamide/brimonidine seems to be an effective and safe alternative alpha-blocker free fixed combination, especially for patients with comorbidities, having its own antihypertensive profile.