In this issue of the Archives, Strahlman and associates1 report a 1-year study of the safety profile and efficacy of a topical carbonic anhydrase inhibitor (CAI), dorzolamide hydrochloride (Trusopt), as either primary or supplemental therapy for primary open-angle glaucoma and ocular hypertension. This is the first topical CAI to show sufficient efficacy for clinical use and that appears to nearly match the pressure-lowering of oral CAIs without having their systemic side effects. Having advanced to Food and Drug Administration phase 3 trials, it was approved early this year2 and marketed in June.
The quest to develop a topically active CAI has taken a long time, generating apt comparisons to the biblical 40-year journey in the wilderness needed to reach the promised land. This journey also was circuitous and skeptics wondered if it would be completed.
The rationale for the development of a topically active CAI was to eliminate
Palmberg P. A Topical Carbonic Anhydrase Inhibitor Finally Arrives. Arch Ophthalmol. 1995;113(8):985–986. doi:10.1001/archopht.1995.01100080035025