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Abstract #19100 Published in IGR 3-1
Twenty-four hour intraocular pressure reduction with latanoprost compared with pilocarpine as third-line therapy in exfoliation glaucoma
Konstas AGP; Lake S; Maltezos AC; Holmes KT; Stewart WCEye 2001; 15: 59-62
PURPOSE: To compare the 24-hour efficacy of latanoprost 0.005% given every evening with that of pilocarpine 4% given four times daily as third-line therapy in patients with exfoliation glaucoma receiving timolol 0.5% and dorzolamide 2% each given twice daily. METHODS: The authors enrolled 30 patients with exfoliation glaucoma not adequately controlled on timolol maleate 0.5% and dorzolamide 2%. Each patient underwent a baseline 24-hour intraocular pressure curve testing at 06:00, 10:00, 14:00, 18:00, 22:00 and 02:00 hours. Patients were randomized to receive either latanoprost 0.005% or pilocarpine 4% for a minimum of eight weeks, and were then crossed over to the opposite therapy. Diurnal curve testing was repeated at the end of each treatment. RESULTS: There was a significant decrease from baseline in intraocular pressure at each time point for both study medicines (p < 0.016). Latanoprost provided better intraocular pressure control than pilocarpine at daytime measurements (17.4 versus 19.7 mmHg at 06:00 hours, p < 0.001; 17.8 versus 19.1 mmHg at 10:00 hours, p = 0.04). However, pilocarpine reduced the pressure more than latanoprost at 22:00 hours (18.4 versus 19.5 mmHg, p = 0.016). Overall, the diurnal intraocular pressure was reduced from a baseline of 21.5 ± 3.7 to 18.8 ± 3.1 mmHg on pilocarpine and to 18.0 ± 3.0 mmHg on latanoprost (p = 0.06). In addition, mean peak pressure was similar between pilocarpine (21.0 ± 2.9 mmHg) and latanoprost (20.5 ± 3.8 mmHg) (p = 0.20). Side-effects were similar with the exception of blurred vision, which was only found with pilocarpine (10%). Compliance was more difficult with pilocarpine. CONCLUSIONS: In exfoliation glaucoma, as a thirdline adjunctive therapy added to timolol and dorzolamide, latanoprost and pilocarpine have similar diurnal efficacy. However, latanoprost provides a greater morning pressure reduction.
Dr. A.G.P. Konstas, University Department of Ophthalmology, AHEPA Hospital, 1 Kyriakidi Street, Thessaloniki 540 06, Greece
Classification:
11.2 Cholinergic drugs (Part of: 11 Medical treatment)
