Efficacy of 2% Pilocarpine on Intraocular Pressure (IOP) Lowering Effect in Uncontrolled Primary Open Angle Glaucoma (POAG) Patients with Maximal Medication

Objective: To evaluate the additive intraocular pressure (IOP) lowering effect of 2% pilocarpine eye drops in medically uncontrollable primary open angle glaucoma (POAG) patients. Materials and Methods: The present study was a retrospective study on POAG patients whose IOP were unable to be controlled with topical hypotensive agents who refused glaucoma surgery. Pilocarpine eye drops (2%) was considered as an additive treatment option. The main measurement was IOP at baseline and after adding pilocarpine eye drops (2%) at 1-, 3- and 6-months. Statistical analysis was described in terms of mean ± standard deviation (SD). Comparisons of numerical variables were done using paired t-test. A p-values of less than 0.05 was considered statistically significant. Results: Thirty-one eyes in 19 patients with open angle glaucoma were enrolled. The mean age of the patients was 62 years. Thirteen patients were male. The mean number of baseline medications was 4.0±0.3. IOP was reduced from 25.0±2.1 mmHg at baseline to 19.0±1.98 mmHg after one month, to 19.0±1.86 mmHg after three months, and to 19.0±1.73 mmHg after six months, which was statistically significant (p<0.001). Conclusion: Pilocarpine eye drops (2%), when used additional with others topical hypotensive agents, was effective for IOP lowering. Patients in the present study reported reduced IOP. The efficacy of pilocarpine eye drops (2%) made it a viable treatment option, particularly for the uncontrollable open angle glaucoma patient who refused glaucoma surgery. Keywords: Pilocarpine eye drops (2%); Intraocular pressure (IOP); Medically uncontrollable; POAG