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Laura Wayman, MS; Lill-Inger Larsson, MD; Todd Maus, MD; Albert Alm, MD, PhD; Richard Brubaker, MD

Arch Ophthalmol. 1997;115(11):1368-1371.

Abstract
Objectives
To measure the effectiveness of topical 2% dorzolamide hydrochloride (Trusopt, Merck & Co Inc, Whitehouse Station, NJ) as a suppressor of aqueous humor flow in the human eye as compared with the effectiveness of 0.5% timolol maleate (Timoptic, Merck & Co Inc) and to measure the additivity of the 2 drugs.

Design
A randomized, double-masked, placebocontrolled study of 40 human subjects was carried out in 2 academic centers (Mayo Clinic, Rochester, Minn, and University of Uppsala, Uppsala, Sweden). The rate of aqueous flow was measured from 8 AM to 4 PM by means of fluorophotometry after administration of doses of each drug singly and both drugs together.

Results
Dorzolamide reduced aqueous flow from 3.07±0.63 µL/min (mean±SD) to 2.53±0.60 µL/min, a reduction of 18% (P<.001). Timolol reduced aqueous flow from the same beginning rate to 1.64±0.35 µL/min, a reduction of 47% (P<.001). The inhibitory effect of timolol was 2.6 times the inhibitory effect of dorzolamide (P<.001). The 2 drugs were almost completely additive, and together reduced the flow to 1.37±0.33 µL/min, a reduction of 55%. Consistent effects were observed on intraocular pressure.

Conclusions
Timolol is more effective than dorzolamide as a suppressor of aqueous humor flow in the normal human eye. Timolol and dorzolamide are additive in their effects, both on aqueous flow and intraocular pressure.

Author Affiliations
From Mayo Medical School, Rochester, Minn (Ms Wayman); Department of Ophthalmology, Uppsala University, Uppsala, Sweden (Drs Larsson and Aim); and Mayo Clinic and Mayo Foundation, Rochester (Drs Maus and Brubaker).

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