Effect of latanoprost/timolol and dorzolamide/tiomolol on intraocular pressure after phacoemulsification surgery

AIM: To evalaute the effect of fixed-combination latanoprost 0.005%/timolol maleate 0.5% and dorzolamide hydrochloride 2%/timolol maleate 0.5% on postoperative intraocular pressure after phacoemulsification cataract surgery. METHODS: This study is a prospective, randomized, double-masked and placebo-controlled. The study included 90 eyes of 90 patients which were scheduled to have phacoemulsification surgery. Patients were randomly assigned preoperatively to 1 of 3 groups (30 eyes of 30 patients). Two hour before surgery, the patients received one drop latanoprost/timolol (group 1), dorzolamide/timolol (group 2) and placebo (group 3, control group). The IOPs were measured at preoperative and postoperative 4, 8, and 24 hours. RESULTS: The preoperative mean intraocular pressure was not statistically significant between both drug groups and control group. In group 1 and 2, the postoperative mean IOP [group1: (14.03±3.15)mmHg and group 2: (14.16±4.43)mmHg] at 24 hours were significantly lower than the control group [(16.93±3.70)mmHg, (P<0.05)]. In addition, the postoperative mean IOP of group 1 [(14.90±3.69)mmHg] at 8 hours was significantly lower than the control group [(17.70±3.89)mmHg, (P<0.05)], but there was no significant difference between group 2 [(16.16±5.23)mmHg] and control group at 8 hours (P>0.05). CONCLUSION: When compared with placebo, the use of preoperative fixed combination of latanoprost/ timolol and dorzolamide/timolol is an effective method for preventing intraocular pressure elevation in 24 hours after phacoemulsification surgery, but did not completely prevent IOP spikes.     

Additive effect of latanoprost and dorzolamide in patients with elevated intraocular pressure

Purpose : To evaluate the additive ocular hypotensive effect of latanoprost and dorzolamide in combination, on intraocular pressure reduction in patients with elevated intraocular pressure (IOP). Methods : Thirty patients with ocular hypertension or early capsular or primary open-angle glaucoma and elevated IOP were randomly assigned to two parallel treatment groups. The treatment period was twenty days. Fifteen patients (Group 1) received latanoprost once daily during the first ten days and, in addition, dorzolamide three times daily during the second ten days. Fifteen patients (Group 2) received dorzolamide three times daily during the first ten days and, in addition latanoprost, once daily during the second ten days. IOP was measured and conjunctival hyperemia was evaluated. Results : In Group 1, the mean IOP on day 0 was 26.8 mmHg; on day 10, 18.7 mmHg; and on day 20, 15.9 mmHg. In Group 2, the mean IOP on day 0 was 26.3 mmHg; on day 10, 21.2 mmHg; and on day 20, 16.1 mmHg. Both groups had clinically significant IOP- lowering effect on day 10 as compared with baseline day (30.2% and 19.4% respectively) (p < 0.01). When dorzolamide was added to latanoprost, the additional IOP reduction was 2.8 mmHg (15%) (p<0.01) compared with 5.1 mmHg (24.1%) (p<0.01when latanoprost was added to dorzolamide. No local serious adverse reactions were observed. A mild but statistically significant increase in conjunctival hyperemia was seen in latanoprost applied patients. Conclusions : The results showed that latanoprost and dorzolamide can be combined successfully to reduce IOP with their additive effects.     

拉坦前列腺素对原发性开角型青光眼患者的疗效

目的:研究拉坦前列腺素对原发性开角型青光眼(POAG)患者的治疗效果.方法:POAG患者135例,随机分为观察组(n=70)和对照组(n=65),观察组给予拉坦前列腺素治疗,对照组给予噻吗心安治疗;记录2组患者治疗前后的眼压及波动值、视野缺损及视网膜纤维层(RNFL)厚度及不良反应.结果:两组患者治疗后昼夜平均眼压、眼压波动值及视野缺损范围均较治疗前明显降低,差异有统计学意义(P＜0.05);治疗后观察组昼夜平均眼压、眼压波动值较对照组降低更明显,下方视野、颞侧视野及鼻侧视野缺损范围较对照组明显缩小,上方视盘、下方视盘、颞侧视盘及鼻侧视盘较对照组明显增厚,差异均有统计学意义(P＜0.05);治疗后观察组9例(12.86％)、对照组11例(16.92％)出现不良反应,差异无统计学意义(P＞0.05).结论:拉坦前列腺素治疗原发性开角型青光眼效果优于噻吗心安.     

Quantitative analysis of eyelash lengthening following topical latanoprost therapy

BACKGROUND: There have been several reports, mostly qualitative, of ocular side effects of latanoprost, including lengthening of eyelashes. We investigated changes in eyelash length in patients receiving topically administered latanoprost. METHODS: Seventeen patients (11 men and 6 women aged 63 to 80 years) with glaucoma or ocular hypertension were treated with latanoprost (one drop to one eye daily at bedtime). All had dark brown irises. At the start of treatment and after 2, 6 and 10 weeks of treatment, a single eyelash was removed from the centre of the upper eyelid of the treated and fellow (control) eyes and measured. Adverse events (defined as any undesirable event occurring in a subject, regardless of whether it was considered related to the latanoprost treatment) were monitored carefully. At each examination patients were asked whether they had any ocular or systemic symptoms. RESULTS: For the eyes treated with latanoprost, the mean eyelash length (and standard deviation) was 5.8 mm (0.7 mm) at baseline, 6.5 mm (0.6 mm) at 2 weeks, 6.5 mm (0.9 mm) at 6 weeks and 6.6 mm (0.7 mm) at 10 weeks (p < 0.001 for all differences from baseline). The corresponding values for the untreated eyes were 5.7 mm (0.7 mm), 5.8 mm (0.7 mm), 5.9 mm (0.7 mm) and 5.6 mm (0.7 mm); all differences were nonsignificant. INTERPRETATION: Latanoprost significantly increases eyelash length.     

三种前列腺素类药物降眼压效果比较

目的比较拉坦前列素、曲伏前列素和贝美前列素三种前列腺素类药物的降眼压效果。方法选取原发性开角型青光眼和高眼压症患者,拉坦前列素组51例(51眼),曲伏前列素组24例(24眼),贝美前列素组27例(27眼),分别使用相应滴眼液,均为每日1次,共观察4周,测量用药前后的眼压值。结果三组患者用药4周后眼压均有明显下降,拉坦前列素组在8:30测得平均眼压从(24.57±3.68)mmHg(1 mmHg=0.133 kPa)降至(15.29±2.67)mmHg,下降幅度(用药前后眼压差值/用药前眼压值)为37.8%;曲伏前列素组从(24.54±2.95)mmHg降至(16.29±3.11)mmHg,下降幅度为33.6%;贝美前列素组从(25.41±3.63)mmHg降至(16.00±4.45)mmHg,下降幅度为37.0%。用药前及用药后三组间眼压值比较,差异均无显著性(分别为F=0.579、P=0.562;F=0.868、P=0.423)。结论拉坦前列素、曲伏前列素、贝美前列素滴眼液对于原发性开角型青光眼和高眼压症患者都有明显、持久的降眼压作用,且降眼压作用相互间没有明显差异。     

Short-term effect of latanoprost on ocular circulation in ocular hypertension

PURPOSE: To determine the short-term effects of latanoprost on retrobulbar circulation in ocular hypertension. METHODS: Forty-six eyes of 23 consecutive bilateral ocular hypertensive patients with an intraocular pressure (IOP) of greater than 22 mmHg were evaluated in a prospective controlled study. All subjects received a single drop of latanoprost 0.005% in one eye and placebo in the fellow control eye. Systemic circulatory parameters, intraocular pressure, blood flow velocities, and resistance indices of the ophthalmic, short posterior ciliary and central retinal arteries were measured using colour Doppler imaging at baseline and 2 h and 8 h after dosing. RESULTS: Latanoprost lowered IOP significantly after 2 h and 8 h (P < 0.01). The mean IOP reduction was 6.7 mmHg 8 h after dosing. At baseline, there were no statistically significant differences in any retrobulbar vessels of eyes that received a single drop of latanoprost when compared with the eyes that received placebo (P > 0.05). Comparisons with baseline and latanoprost conditions revealed that latanoprost did not alter the blood flow velocities and resistance indices in the ophthalmic (P > 0.05), posterior ciliary (P > 0.05) and central retinal (P > 0.05) arteries 2 h and 8 h after dosing. The systolic and diastolic blood pressures (p = 0.74, p = 0.29, respectively) and pulse rate (p = 0.68) remained unchanged over the 8-h period. CONCLUSIONS: This study found that a single drop of latanoprost significantly reduces intraocular pressure 8 h after dosing. However, it does not have any short-term effects on the retrobulbar haemodynamics in ocular hypertensive eyes.     

Studies on ocular inflammation and development of a prostaglandin analogue for glaucoma treatment

This review summarizes the Ernst H. Bárány Prize Lecture given at the meeting of the International Society of Eye Research in Geneva 2002. In the paper the path from the author's early studies on neurogenic inflammation in the eye to the search for a suitable prostaglandin analogue for glaucoma treatment, and the development of latanoprost are described. In particular the solution to the nociceptive and hyperemic side-effects of naturally occurring prostaglandins in the eye, the mechanism of action of FP prostanoid receptor agonists as well as the selection of dose for glaucoma treatment are discussed. In addition, pharmacokinetical aspects of latanoprost, and the melanogenic side-effect of prostaglandins in the iris are addressed. The paper is primarily focused on studies performed by the author and complete reference to other previous, or contemporary studies is therefore not always given as the purpose is not to present a comprehensive review article.     

A Prospective Study of Iridial Pigmentation and Eyelash Changes Due to Ophthalmic Treatment with Latanoprost

Purpose To conduct a 12-month prospective study on the occurrence of latanoprost-induced iridial pigmentation and eyelash change in Japanese patients with glaucoma.Methods Seventy-five patients (75 eyes) were enrolled in the study. Photographs of the iris and eyelashes were taken under identical conditions before and after treatment. Three glaucoma specialists assessed the iridial pigmentation/eyelash change independently with no knowledge of patient data. The effects of age, sex, concomitant medication, and type of glaucoma on iridial pigmentation/eyelash change were investigated, and intraocular pressure (IOP) reduction and iridocorneal angle pigmentation before and after latanoprost treatment were compared between patients with iridial pigmentation/eyelash change and patients without these changes.Results The incidence of iridial pigmentation was 6.3% at 1 month, 15.7% at 3 months, 37.8% at 6 months, and 56.5% at 12 months. The incidence of eyelash change was 0% at 1 month, 33.8% at 3 months, 44.4% at 6 months, and 46.2% at 12 months. Latanoprost did not affect IOP reduction or iridocorneal angle pigmentation. No significant relationship between iridial pigmentation and eyelash change was observed. None of the investigated parameters except age affected the iridial pigmentation/eyelash change.Conclusion Iridial pigmentation and eyelash change occurred at a high frequency in long-term treatment with latanoprost in Japanese glaucoma patients. Jpn J Ophthalmol 2004;48:141–147 © Japanese Ophthalmological Society 2004     

Switch to Latanoprost Monotherapy from Combined Treatment with β-Antagonist and Other Antiglaucoma Agents in Patients with Glaucoma or Ocular Hypertension

Purpose To investigate the effects on intraocular pressure (IOP) and the occurrence of adverse events upon switching directly to latanoprost monotherapy from multiple drug therapy, including a -antagonist, for glaucomatous eyes.Methods Patients with primary open-angle glaucoma or ocular hypertension and receiving long-term therapy with two or three topical ocular hypotensive drugs (including one topical -antagonist) were switched to latanoprost monotherapy for 12 weeks without any intervening washout period. Observations were performed before switching (baseline) and at weeks 4, 8, and 12 after switching to latanoprost monotherapy.Results Of the 29 enrolled patients, 26 (90%) completed this protocol. Three patients had excessive IOP elevation, and these patients were withdrawn. The switch to latanoprost monotherapy was followed by a significant (P < 0.0001) mean reduction of 3.9mmHg at week 12 in per-protocol cases (n = 26) and a significant (P = 0.0016) mean reduction of 2.8mmHg at last postswitch visit in patients in the intent-to-treat analysis group (n = 29). Adverse ocular events other than IOP elevation were mild.Conclusions The switch to latanoprost monotherapy in glaucoma patients receiving multiple drug therapy resulted in an additional, significant IOP reduction. Jpn J Ophthalmol 2004;48:276–280 © Japanese Ophthalmological Society 2004     

Ocular hypotensive efficacy of brimonidine 0.15% as adjunctive therapy with latanoprost 0.005% in patients with open-angle glaucoma or ocular hypertension

This study was undertaken to evaluate the ocular hypotensive efficacy of brimonidine Purite 0.15% (Alphagan P 0.15%; Allergan, Inc., Irvine, Calif) given as adjunctive therapy with latanoprost 0.005% (Xalatan; Pfizer Inc., New York, NY( to patients with open-angle glaucoma or ocular hypertension. In this multicenter, open-label, prospective evaluation, the intraocular pressure (IOP) of the 43 enrolled patients was > or =18 mm Hg after at least 6 wk of latanoprost monotherapy. The primary outcome measure was IOP at peak drug effect )10 AM, or approximately 2 h after the morning dose of brimonidine 0.15%(. IOP at trough drug effect (8 AM, or approximately 12 h after the evening dose of brimonidine) was also measured. Baseline IOP was 21.9 (+/-2.3) mm Hg. After 1 mo of treatment, additional mean IOP reductions from latanoprost-treated baseline values were 5.8 mm Hg (26%) at peak drug effect (P<.001) and 3.3 mm Hg (15%) at trough (P<.001). At the month 2 visit, additional mean IOP reductions from latanoprost-treated baseline values were 5.1 mm Hg (23%) at peak drug effect (P<.001) and 2.0 mm Hg (9%) at trough (P=.002). Brimonidine Purite 0.15% provided statistically significant additional reductions in IOP from latanoprost-treated baseline values. These findings suggest that brimonidine Purite 0.15% is an efficacious adjunctive therapy in patients given latanoprost who require additional lowering of IOP.