One eye of each of 12 patients with uncontrolled glaucoma of various types received apraclonidine 1% in addition to a maximally tolerated medical regimen (11 of 12 patients were taking three or four different medications). In eyes with an apparent response to a single dose, apraclonidine was continued twice daily until intraocular pressure was thought to be inadequate or until adverse effects occurred. The duration of treatment varied from a single drop to 44 weeks. The mean intraocular pressures before and after apraclonidine treatment were 23.4 ± 1.5 (±SEM) and 21.0 ± 1.7 mm Hg, respectively (p < 0.05). The mean reduction in intraocular pressure was at least 3 mm Hg in eight eyes (67%) was as much as 6 mm Hg in three of these eight eyes. Some eyes exhibited a gradual rise in intraocular pressure during the course of treatment. One eye developed an apparent allergic reaction. These results show only a mild additive effect and suggest tachyphylaxis when apraclonidine is used in eyes already treated with maximally tolerated ocular hypotensive medications.
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Lish et al. (1992) studied this question.