Dorzolamide / timolol and brinzolamide / brimonidine fixed combination topical drug therapy tn the management of intraocular pressure in primary open angle glaucoma.

Objective: To compare the mean change in intraocular pressure (IOP) achieved with dorzolamide/timolol versus brinzolamide/brimonidine fixed combination topical therapy in patients diagnosed with primary open-angle glaucoma (POAG). Study Design: Randomized Control Trial. Setting: Department of Ophthalmology, Mayo Hospital, Lahore. Period: May’2024 to October’2024. Methods: A total of 60 cases aged 40–70 years with primary open-angle glaucoma were included and randomly assigned to receive either dorzolamide/timolol (Group X) or brinzolamide/brimonidine (Group Y). IOP was measured weekly for four weeks using Goldman tonometry, with the primary outcome being mean IOP reduction at week four. Results: The mean baseline IOP was comparable in both groups (p=0.947). After 4 weeks, IOP reduction was significantly greater in Group Y (6.84 ± 2.34 mmHg) than Group X (5.37 ± 2.16 mmHg) (p=0.014). Stratified analysis showed a significant IOP reduction in older patients (56–70 years) and in females treated with brinzolamide/brimonidine (p=0.006 and p=0.049, respectively). Conclusion: Brinzolamide/brimonidine fixed combination therapy was more effective in reducing IOP than dorzolamide/timolol, especially in older patients and females, suggesting a potential demographic influence on drug response.