Phospholine Iodide (217m1) (ecothiophate Iodide) in the Treatment of Glaucoma.

(CH3)3 . N. CH2. CH2-S-P(z=0) (OC2H5)2.I The first report of its clinical use as a miotic in the treatment of glaucoma came from Leopold, Gold, and Gold (1957). Krishna and Leopold (1959) reported their results in 110 eyes of 62 patients with glaucoma treated with it for continuous periods extending, in many cases, up to 2 years without surgical intervention. Becker, Pyle, and Drews (1959) reported its effect on the coefficient of aqueous outflow in thirty normal and 65 glaucomatous human eyes. Becker and Gage (1960) described the effects of phospholine iodide in a series of 144 eyes and of decamarium bromide in a series of 155 eyes with various forms of glaucoma, giving further details of tonographic and other results and describing the local and systemic side-effects which were encountered. Drance and Carr (1960) reported the results of using phospholine iodide in five eyes of normal subjects and in 59 non-operated eyes showing "chronic simple" glaucoma. Later Drance reported his results in 33 eyes for periods ranging from 12 to 24 months (Drance, 1960). Pharmacological studies, especially on the impermeability of the blood-brain barrier to phospholine iodide, were reported by Koelle and Steiner (1956). Its site of action has been studied by Mclsaac and Koelle (1958) and Koff and Coon (1959), and its toxicity by Schaumann and Job (1958), Mamo and Leopold (1958), and Jewell and Lehmann (1958). The present paper attempts a detailed description of all the cases which could be traced (viz. 72 patients, 115 eyes) in which the drug was used by my two colleagues and myself at Oxford Eye Hospital during the 4 years from March, 1958, to March, 1962.