Maximising glaucoma treatment outcomes
Fixed combinations of IOP-lowering medications provide several advantages in clinical practice over unfixed combinations.


Cheryl Guttman Krader
Published: Thursday, March 23, 2017

Approximately half of patients with open-angle glaucoma need more than one medication to reach target IOP.“Some doctors only know the commercial brand name of the fixed combination. If they cannot make an educated guess about a causal relationship with one of its ingredients, it will be necessary to stop the fixed combination and restart therapy, building it up in a stepwise manner,” he said. Cost may also be lower with a fixed combination product. Dr Holló said the limitations of fixed combination drops are minor compared with the benefits. Although IOP reduction in controlled comparative trials was greater using two drugs as an unfixed combination than as a fixed combination, the difference was minimal, and not clinically significant. Another downside of fixed combinations is that they limit dosing flexibility. Dr Holló suggested, however, this issue is only rarely important. “Special attention may be required for a patient who needs smoothing of a funny IOP spike during the day, and in that situation we cannot use the fixed combination,” he explained.
Tags: glaucoma, medication
Latest Articles
ESCRS Today 2025: Happy Anniversaries!
ESCRS celebrates milestones with pioneers in IOLs, LASIK, femtosecond lasers, and corneal transplantation.
ESCRS Today 2025: A Congress for Everyone
From YOs to families, the ESCRS Annual Meeting embraces full participation through inclusivity.
Beyond the Numbers
Empowering patient participation fosters continuous innovation in cataract surgery.
Thinking Beyond the Surgery Room
Practice management workshop focuses on financial operations and AI business applications.
Aid Cuts Threaten Global Eye Care Progress
USAID closure leads retreat in development assistance.
Supplement: ESCRS Clinical Trends Series: Presbyopia
Debate: FS-LASIK or KLEx for Hyperopia?
FS-LASIK has more of a track record, but KLEx offers advantages.
Four AI Applications Ready for Practice
Commercial offerings may save time, improve practice and research.
Perioperative Medication Regimens for Cataract Surgery
Randomised controlled clinical trial results provide evidence-based guidance.