Topical timolol reverses post-LASIK myopic regression

Treatment with timolol maleate 0.5% can partially reverse myopic regression after LASIK for high myopia, said Joseph Frucht-Perry, MD, Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.

"Our experience in a series of 32 eyes showed twice daily use of the topical beta-blocker was associated with statistically significant reduction in myopia and improvement in uncorrected vision," Dr. Frucht-Perry said. "However, the effect on refraction is drug-dependent. While it was maintained with long-term treatment, the benefit terminated if timolol was discontinued, and there was less improvement in myopia following treatment renewal."

The 32 eyes on which he reported had a mean standard error (SE) prior to LASIK of –9.6 D (range –5.75 to –14.75 D) and a mean residual myopia of –1.87 D at 2 to 36 months postop. In all eyes, residual myopia was at least –1 D and was associated with decreased visual acuity.

Timolol was administered twice daily. After an average of about 1.8 months, mean SE improved to –0.94 D and mean UCVA had improved from 0.34 to 0.63. IOP did not change significantly.

Eleven patients stopped timolol after 5 to 20 months, and the discontinuation was associated with a regression of myopia to pretreatment levels. Mean SE among patients who restarted timolol was significantly lower than among patients who maintained ongoing treatment, –1.59 versus –1 D, respectively.