THE FREQUENCY OF CATARACT AFTER MIOTIC THERAPY

The appearance of undesirable side effects after miotic therapy is a common experience. These side effects are mostly local and of minor importance. Individual cases have been reported, where a developing cataract might possibly have been attributed to the miotics used. However, to our knowledge no systematic investigations have been made with regard to the possible cataractogenic effect of miotics. In 1960, phospholine iodide in the strength of 0.25 % was introduced in our department. At that time it was reserved for cases of chronic simple or secondary glaucoma where previous therapy had failed. Some of these cases, treated with phospholine iodide, showed a rather rapid development of cataract. However, they represent only individual cases where the primary disease was as a rule far advanced. Therefore, the cataract may not necessarily be correlated to the miotic used. In 1963, when phospholine iodide in the strength of 0.06 and 0.125 "/o became available, an investigation was started to evaluate the effect and advantage of phospholine iodide as compared to pilocarpine, in early cases of chronic simple glaucoma. For that reason, all eyes with new-diagnosed chronic simple glaucoma were treated with phospholine iodide from the very beginning. During the follow-up of these patients, cases were noticed in which specific lens opacities or progressive refraction changes developed. As phospholine iodide was suspected to be the cause of these changes, a systemic investigation was started to evaluate the frequency of lens changes in eyes treated with phospholine iodide as compared to eyes treated with pilocarpine.