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Abstract #8137 Published in IGR 4-3
Efficacy of latanoprost additive therapy on uncontrolled glaucoma
Bayer A; Tas A; Sobac G; Henderer JDOphthalmologica 2002; 216: 443-448
PURPOSE: To assess the efficacy of latanoprost as an additive therapy in patients with open-angle glaucoma and an intraocular pressure (IOP) deemed to be too high on maximum-tolerated medical therapy. STUDY DESIGN: Prospective case series. METHODS: Consecutive patients with open-angle glaucoma, presenting to the Gulhane Military Medical Hospital Ophthalmology Clinic from May 1999 to September 2000, were enrolled. The effect of latanoprost on IOP was followed during a period of 12 months. The criterion for success was defined as having an IOP reduction of at least 20% from baseline or a final IOP of less than 22 mmHg. Several clinical pretreatment variables (age, gender, ocular laterality, type of glaucoma, number of antiglaucomatous medications at study entry, pretreatment IOP) were analyzed for a significant effect on the efficacy of latanoprost additive therapy. MAIN OUTCOME MEASURE: IOP. RESULTS: Sixty-five eyes of 35 patients were included. The mean baseline IOP ± SD was 23.3 ± 2.0 mmHg. Two patients (5.71%) developed ocular allergy in the first month, requiring cessation of latanoprost. In the remaining 61 eyes of 33 patients, IOP was significantly reduced compared with baseline measurements with a mean IOP reduction of 6.1 ± 1.8 (26.1%), 6.0 ± 2.2 (25.3%), and 5.5 ± 2.4 (23.2%) mmHg at the one-, three- and six-month follow-up controls, respectively (p < 0.001). Successful outcome was obtained in 50 (76.9%), 46 (70.7%) and 38 (58.4%) of 65 eyes at the one, three, and six-month visits, respectively. During the period from six to 12 months, 28 eyes underwent either a combined procedure (cataract extraction + intraocular lens implantation + trabeculectomy; eight eyes) or only trabeculectomy (20 eyes) because of uncontrolled IOP; four eyes underwent the combined procedure because of visually significant cataract, and eight eyes were lost to follow-up. Sixteen of 21 eyes followed for more than 12 months with the same medications continued to have a successful outcome, and the mean IOP of 18.8 ± 3.7 mmHg was significantly different from baseline (p < 0.001). None of the pretreatment variables was a significant prognostic factor for failure of latanoprost additive therapy. CONCLUSIONS: This study supports the use of latanoprost additive therapy in patients with elevated IOP already receiving maximum-tolerated medical therapy.
A. Bayer, MD, Gulhane Askeri Tip Akademisi, Goz Hst AD. 06018, Etlik, Ankara, Turkey. atillabayer@hotmail.com
Classification:
6.11 Bloodflow measurements (Part of: 6 Clinical examination methods)
