Effect of treatment by medicine or surgery on intraocular pressure and pulsatile ocular blood flow in normal-pressure glaucoma

Graefes Arch Clin Exp Ophthalmol. 2002 Sep;240(9):721-6. doi: 10.1007/s00417-002-0504-9. Epub 2002 Aug 13.


Purpose: To study the effect of trabeculectomy and monotherapy with topical betaxolol, brimonidine and latanoprost on intraocular pressure (IOP) and pulsatile ocular blood flow (POBF) in patients with normal-pressure glaucoma (NPG).

Methods: In this retrospective study NPG patients attending the glaucoma research unit at Moorfields Eye Hospital were reviewed. Patients treated by surgery or topical medication (betaxolol, brimonidine or latanoprost) who had pre- and post-treatment IOP and POBF measurements were studied. For those patients who were having treatment to both eyes, one eye was selected at random for analysis.

Results: A total of 147 patients were reviewed. Forty-three eyes were receiving betaxolol 0.5%, 58 eyes latanoprost 0.005%, 23 eyes brimonidine 0.2% and 23 eyes had undergone trabeculectomy surgery. There were more female than male patients in all four groups, and the groups were similar with regards age. Pre-treatment IOP and POBF values were similar among the groups ( P=0.27, P=0.08 respectively). Post-treatment IOP values tended to be lower than pre-treatment values for all four groups. All groups had an increased POBF except for betaxolol, where POBF decreased.

Conclusion: Patients treated by trabeculectomy and those receiving topical latanoprost and brimonidine had lower IOP and higher POBF following treatment. The betaxolol-treated group, despite a slight decrease in IOP, had a decreased POBF. Lowering IOP by treatment may not necessarily be associated with an increase in POBF.

Publication types

  • Comparative Study

MeSH terms

  • Administration, Topical
  • Aged
  • Antihypertensive Agents / therapeutic use*
  • Betaxolol / therapeutic use
  • Blood Flow Velocity
  • Brimonidine Tartrate
  • Eye / blood supply*
  • Female
  • Glaucoma, Open-Angle / physiopathology*
  • Glaucoma, Open-Angle / therapy
  • Humans
  • Intraocular Pressure / drug effects*
  • Latanoprost
  • Male
  • Ophthalmic Solutions
  • Prostaglandins F, Synthetic / therapeutic use
  • Pulsatile Flow
  • Quinoxalines / therapeutic use
  • Retrospective Studies
  • Tonometry, Ocular
  • Trabeculectomy / methods*


  • Antihypertensive Agents
  • Ophthalmic Solutions
  • Prostaglandins F, Synthetic
  • Quinoxalines
  • Brimonidine Tartrate
  • Latanoprost
  • Betaxolol