Effect of vehicle on pilocarpine-induced ocular hypotension

One-month crossover trial comparing the intraocular pressure control of 3.4% Piloplex twice daily with 2.0% pilocarpine four times daily

A one-month crossover trial comparing Piloplex 3.4% b.i.d. with pilocarpine 2.0% q.i.d. was conducted to compare the effectiveness of the 2 drugs in reducing the intraocular pressure of ocular hypertensive and open-angle glaucoma in subjects previously controlled with pilocarpine 2.0%. For both groups the mean IOP increased slightly from baseline with pilocarpine and decreased significantly from baseline with Piloplex. The side effects of both treatments were minor. Piloplex and pilocarpine treatment were both associated with eye dryness; Piloplex was associated with lacrimation in 2 subjects. This controlled study showed that Piloplex 3.4% b.i.d. was more effective than pilocarpine 2% q.i.d. in lowering intraocular pressure.

Comparative study of aqueous and oily pilocarpine in the production of ocular hypotension

The effective use of aqueous and oily pilocarpine was studied in 19 glaucomatous eyes. The aqueous drops were used 4 times a day while the oily drops were used only twice. It was found that the oily drops were better than the aqueous drops in lowering the mean intraocular pressure and the maximum pressure reached during the day. no statistically significant difference was found between the 2 pilocarpine treatments in the reduction of daily variation of intraocular pressure. It is felt that oily drops used only twice a day would lead to better patient compliance and better control of chronic simple glaucoma.

Efficacy and patient acceptance of pilocarpine gel

Fifteen patients with symmetrically increased intraocular pressure (IOP) participated in a single-masked random 30-day clinical trial comparing 4% pilocarpine hydrochloride gel applied at bedtime to one eye with 4% pilocarpine hydrochloride drops instilled four times daily in the fellow eye. Both forms of pilocarpine reduced IOP significantly at 8 A.M., 12 noon, and 4 P.M. (P less than .01). At these times there was no significant difference in effect between the two forms of pilocarpine (P greater than .05). The mean IOP of eyes treated with gel showed no significant difference from the pretreatment value at 10 P.M. (P = .37), whereas at this time eyes treated with drops did maintain a significant IOP reduction (P = .02). At 10 P.M. pilocarpine drops reduced IOP significantly more than did pilocarpine gel (P = .002). Pupil diameter was affected by the gel and drops in a similar pattern to that of IOP. Patients tolerated the gel with few side effects and were pleased by the convenience of administration once daily.

Effect of oily vehicle on ocular pilocarpine concentration

The effect of 1.4% polyvinyl alcohol (PVA) vehicle and of castor oil vehicle on ocular pilocarpine concentration was studied by radioactive method in the rabbit eye. Statistically higher radioactivities were measured from the anterior surface structures of the eyes dropped with oily vehicle when compared to PVA vehicle at 120 min. It is concluded that the conjunctiva and the cornea serve as a drug reservoir for the longlasting drug effect observed in the literature after oily pilocarpine drops.