The principal use of anticholinesterase agents (cholinesterase inhibitors) in opthalmology is in the treatment of glaucoma, where they effectively lower the intraocular pressure when instilled locally into the eyes. These agents fall into two categories depending upon their duration of action, one the short-acting cholinesterase inhibitors, which inhibit cholinesterase reversibly, and the other the long-acting cholinesterase inhibitors, which inhibit cholinesterase irreversibly. Physostigmine (Eserine) and neostigmine (Prostigmine) are the reversible cholinesterase inactivators and diisopropyl fluorophosphate or DFP (Floropryl) the irreversible cholinesterase inactivator generally employed.In 1957, Leopold, Gold, and Gold introduced a new potent long-acting irreversible cholinesterase inhibitor, echothiophate (Phospholine) iodide (217-MI), in ophthalmology and reported their experience with this drug in treatment of glaucoma. Recent reports by Becker, Pyle, and Drews; Lawlor and Lee, and Seward and Albert confirmed the favorable results reported in this initial study. All these studies
KRISHNA N, LEOPOLD IH. Echothiophate (Phospholine) Iodide (217-MI) in Treatment of Glaucoma: Further Observations. AMA Arch Ophthalmol. 1959;62(2):300–313. doi:10.1001/archopht.1959.04220020126019
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