Long-term experience with apraclonidine 0.5% (Iopidine) in clinical practice

Purpose. This study was performed to evaluate the long-term clinical response of Iopidine 0.5% in glaucoma patients. This included IOP reduction, allergy, and additivity with other classes of antiglaucoma drugs, Methods. A retrospective review of all chronic glaucoma patients begun on treatment with Iopidine 0.5% between September, 1993 and August, 1995 was performed. Patients previously treated with this agent or in whom multiple changes in the medical regimen were performed simultaneously were excluded. Data including demographics, IOP, allergic response, and further intervention was recorded. Results. A total of 280 patients were treated with apraclonidine 0.5%, of whom 174 patients met the inclusion and exclusion criteria for this study. In these patients, compared to the pretreatment baseline, there was an IOP decrease of 19% at one month, 22.49% at three months, 26.12% at sixth months, 23.33% at 12 months, and 22.19% at 24 months. The overall allergy incidence was 21.83% (38 patients). The drug was determined to be ineffective by one-eyed therapeutic trial or return to pretreatment pressure in 21.83% (38 patients). In the remaining 126 patients in whom the drug was effective, there was a 26%, 26.4%, 29.2%, 27.5%, and 22.5% reduction in IOP at 1, 3, 6, 12, and 24 months respectively. Conclusion. This study showed apraclonidine 0.5% to significantly reduce IOP with a lower incidence of allergic reactions than some have reported. Iopidine 0.5% appears to be an effective drug in the treatment of chronic glaucoma and should be considered in the treatment of chronic glaucoma.