Intraocular Pressure Outcomes Following Initiation of A Triple Fixed-Dose Combination of Brimonidine, Timolol, and Brinzolamide: A Prospective Observational Study

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Purpose: To evaluate intraocular pressure (IOP) outcomes and topical medication-bottle burden following initiation of a triple fixed-dose combination (FDC) of brimonidine 0.2%, timolol 0.5%, and brinzolamide 1%. Methods: This prospective, multicentre observational study included 142 patients with different glaucoma subtypes. Treatment was initiated independently by the treating ophthalmologist before study enrolment. One eye per patient was analysed, with the more severely affected eye selected when both eyes were eligible. The triple FDC was prescribed twice daily, with follow-up at 4 weeks, 3 months, and 6 months. Results: Mean IOP decreased from 23.67 ± 9.94 mmHg at baseline ( n = 142) to 18.34 ± 6.14 mmHg at 4 weeks ( n = 142), 18.23 ± 5.57 mmHg at 3 months ( n = 141), and 18.10 ± 5.28 mmHg at 6 months ( n = 134). Among 134 patients with paired six-month data, mean IOP reduction was 5.57 mmHg (21.9% of the paired baseline mean; p < 0.001), and 85 (63.4%) had IOP ≤18 mmHg. The proportion using three or more bottles decreased from 26.1% (37/142) at baseline to 3.5% (5/142) in the initial post-switch prescription. Conclusion: Initiation of a treatment regimen incorporating the triple FDC was associated with lower IOP and reduced medication-bottle burden. The uncontrolled design, concomitant medications, and incomplete adverse-event documentation limit causal interpretation and preclude reliable safety conclusions.