FURTHER INTRAOCULAR  PRESSURE LOWERING EFFECT IN GLAUCOMATOUS EYES AFTER SWITCH TO LATANOPROST AS SINGLE OR COMBINED THERAPY.

D. Doro, D. Genesin, P. Maimone and F. Busca

Dept. of Ophthalmology University of Padua, Italy

Purpose: to verify the intraocular pressure (IOP) lowering effect of Latanoprost as single or combined therapy in eyes with primary open angle glaucoma and adverse effects to previous drugs or uncontrolled IOP.  

Patients and methods: a prospective non randomized study was conducted for three to six months on both eyes of 54 patients. In  30 eyes (group A) 0.5% Timolol was substituted with  Latanoprost; in 18 eyes (group B) on Timolol , Latanoprost was added ; 22 eyes (group C) on Timolol and Dorzolamide were given Latanoprost only; 16  eyes (group D) on Timolol and Dorzolamide, Timolol only was substituted with Latanoprost ; 12 eyes (group E) on bid Timolol and 2% Pilocarpine were given Latanoprost only; 10 eyes (group F) with narrow angle and no laser iridotomy on tid 2% Pilocarpine were switched to Latanoprost only.  

Results: in  group A, B, C, D, E and F mean IOP further reduction was 3.2  (- 15.5%) , 4.5  (- 19.8%) , 0.8 (- 4%), 2.8 (-12.3%) , 0.5 (-2.8%) and 4.0mmHg (-17.4%)  respectively.  Four patients on Latanoprost complained of  ocular itching, redness or discomfort.

Conclusion: a minimal mean additional IOP lowering effect of Latanoprost was found in eyes previously treated with Timolol plus Dorzolamide or Pilocarpine. Latanoprost alone performed much better in eyes receiving Timolol or Pilocarpine only. The addition of Latanoprost to Timolol or Dorzolamide furtherly reduced IOP. Better IOP control and improvement of  the quality of vision in eyes on miotic therapy could be achieved  with Latanoprost monotherapy