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Randomized Controlled Trial
. 2006 Nov;142(5):800-10.
doi: 10.1016/j.ajo.2006.06.052.

Topical ocular hypotensive medication and lens opacification: evidence from the ocular hypertension treatment study

David C Herman  1 , Mae O Gordon, Julia A Beiser, Leo T Chylack Jr, Kathleen A Lamping, Oliver D Schein, Joern B Soltau, Michael A Kass; Ocular Hypertension Treatment Study (OHTS) Group
Affiliations
Randomized Controlled Trial

Topical ocular hypotensive medication and lens opacification: evidence from the ocular hypertension treatment study

David C Herman et al. Am J Ophthalmol. 2006 Nov.

Abstract

Purpose: To determine whether topical ocular hypotensive medication is associated with refractive changes, visual symptoms, decreased visual function, or increased lens opacification.

Design: Multi-center clinical trial.

Methods: We compared the medication and observation groups of the Ocular Hypertension Treatment Study (OHTS) during 6.3 years of follow-up with regard to the rate of cataract and combined cataract/filtering surgery, and change from baseline in visual function, refraction, and visual symptoms. A one-time assessment of lens opacification was done using the Lens Opacities Classification System III (LOCS III) grading system.

Results: An increased rate of cataract extraction and cataract/filtering surgery was found in the medication group (7.6%) compared with the observation group (5.6%) (hazard ratio [HR] 1.56; 95% confidence interval [CI] 1.05 to 2.29). The medication and observation groups did not differ with regard to changes from baseline to June 2002 in Humphrey visual field mean deviation, Humphrey visual field foveal sensitivity, Early Treatment of Diabetic Retinopathy Study (ETDRS) visual acuity, refraction, and visual symptoms. For the medication and observation groups, LOCS III readings were similar for nuclear color, nuclear opalescence, and cortical opacification. There was a borderline higher mean grade for posterior subcapsular opacity in the medication group (0.43 +/- 0.6 SD) compared with the observation group (0.36 +/- 0.6 SD) (P = .07).

Conclusions: We noted an increased rate of cataract extraction and cataract/filtering surgery in the medication group as well as a borderline higher grade of posterior subcapsular opacification in the medication group on LOCS III readings. We found no evidence for a general effect of topical ocular hypotensive medication on lens opacification or visual function.

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Figures

Figure 1
Figure 1
Comparison of the Observation Group and the Medication Group in the cumulative proportion of participants with ≤ 39 letters correct on ETDRS visual acuity (approximately 20/40 Snellen equivalent) before June 2002 or a censoring event.
Figure 2
Figure 2
Comparison of the Observation Group and the Medication Group in the cumulative probability of participants with Humphrey mean deviation (p <0.05) on any field prior to June 2002 or a censoring event.
Figure 3
Figure 3
Comparison of the Observation Group and the Medication Group in the cumulative probability of participants having cataract extraction or combined cataract/filtering surgery from baseline to June 2002.
Figure 4
Figure 4
Comparison of the Observation Group and the Medication Group in the distribution of LOCS III posterior subcapsular opacity grades in the worse eye.
See this image and copyright information in PMC

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