Impact of Eyelid Closure on the Intraocular Pressure Lowering Effect of Prostaglandins: A Randomized Controlled Trial

摘要

Purpose: : To determine if eyelid closure (ELC) after topical prostaglandin instillation provides greater intraocular pressure (IOP) reduction than prostaglandin instillation without ELC. Methods: : Patients receiving chronic bilateral prostaglandin monotherapy were enrolled in this study. The study intervention, ELC, was randomly assigned to one eye, while the fellow eye served as control. ELC was performed for either 1 minute or 3 minutes. The main outcome was difference in IOP lowering effect from baseline in the intervention versus control eye. After a one day washout, the IOP was measured in a masked fashion at baseline, 1 hour, 24 hours and a final visit that took place 7-14 days after enrollment. All visits were scheduled during the morning, and every individual patient's visits occurred at similar times during the day. Results: : Fifty one patients meeting eligibility criteria were enrolled, 25 were randomized to ELC for 1 minute and 26 to ELC for 3 minutes in the intervention eye. The pooled IOP lowering difference ([95% CI], p value) in intervention versus control eyes was 0.24mmHg ([Fifty one patients meeting eligibility criteria were enrolled, 25 were randomized to ELC for 1 minute and 26 to ELC for 3 minutes in the intervention eye. The pooled IOP lowering difference ([95% CI], p value) in intervention versus control eyes was 0.24mmHg ([-0.4: 0.9], p = 0.47), 0.24 mmHg ([-0.7: 1.1], p= 0.61) and 0.25mmHg ([-0.6: 1.1], p=0.58) in the overall group, 1 min ELC subgroup and 3 min ELC subgroup respectively. The effect of ELC did not change significantly across visits. Conclusions: : Eyelid closure did not provide additional IOP reduction compared to no eyelid closure in patients under chronic prostaglandin monotherapy. Clinical Trial: : http://www.clinicaltrials.gov NCT00832832.