拉坦前列素隔日给药对青光眼患者眼压的影响

目的:探讨隔日应用0.005%拉坦前列素对青光眼患者眼压(intraocular pressure,IOP)的效果。方法:该研究中的开角型青光眼患者控制较好,在研究的第一阶段睡前给予拉坦前列素,每日一次,至少2mo。3次连续IOP正常后,改为隔日一次睡前用药,并且在研究第二阶段的1,2,4,6,8和12wk密切监测患者,进行IOP测量。遇到一次IOP异常升高,则患者被排除研究并且前期方案将重建。结果:这项研究包括53例53眼开角型青光眼(男29例,女24例,年龄52～82岁)。27例患有原发性开角型青光眼,26例患有假性剥脱性青光眼。研究的第二阶段开始后,IOP有温和增长趋势,并分别在女性和男性患者中检测到。第1,2,4,6,8和12wk的P值分别为0.003,0.001,0.000,0.000,0.000和0.000。在第二阶段开始后的前2wk,66%的病例没有IOP改变,但此后,69.8%患者眼压增加。结论:该研究显示常规用量0.005%拉坦前列素与隔日一次剂量相比,具有优越性,但至少在最初的几个星期,IOPs比较接近对方。进一步的多患者研究将扩大目前的研究结果。

The effect on intraocular pressure of Latanoprost with once every other day dosing in glaucoma patients

AIM: To evaluate the effect on intraocular pressure(IOP)of Latanoprost 0.005%(Lataprost, Sina Darou, Iran)applied every other day.

METHODS: Patients with well controlled open angle glaucoma were enrolled in the study. All patients had been given Latanoprost for at least 2 months with once daily dose at bed time at the first phase of the study. After recovery of 3 normal consecutive IOPs, the dosage was altered to once every other day at bed-time and they were closely monitored at week 1, 2, 4, 6, 8 and 12 within second phase of the study and IOPs were measured. As soon as an abnormally elevated IOP was encountered, patient was excluded from the study and the prior regimen was reestablished.

RESULTS:This study included 53 eyes of 53 patients(29 male, 24 female; age range 52-82 years)with open angle glaucoma. Twenty-seven patients suffered from primary open angle glaucoma and 26 patients had pseudoexfoliative glaucoma. After beginning the second phase of the study, a mild trend of increasing IOP was recordable. A corresponding trend was even detected in female and male patients separately. The P values at week 1, 2, 4, 6, 8 and 12 were 0.003, 0.001, 0.000, 0.000, 0.000 and 0.000 respectively. In the first 2 weeks after initiation of the 2^nd phase, 66% of cases have no change in IOPs, but thereafter, 69.8%, experienced increasing IOPs.

CONCLUSION: The present study shows the superiority of the conventional dosage of Latanoprost 0.005% in comparison with once every other day dose but at least in first few weeks, the IOPs are reasonably close to each other. Further studies with higher number of cases would widen the present findings.