EXTENDED REPORT

Diurnal IOP control with bimatoprost versus latanoprost in exfoliative glaucoma: a crossover, observer-masked, three-centre study

A G P Konstas¹, G Holló², M Irkec⁴, S Tsironi³, I Durukan⁴, M Goldenfeld⁵ and S Melamed⁵

¹ Glaucoma Unit, 1st University Department of Ophthalmology, AHEPA Hospital, Thessaloniki, Greece
² Department of Ophthalmology, Semmelweis University, Budapest, Hungary
³ Department of Ophthalmology, Papanikolaou Hospital, Thessaloniki, Greece
⁴ Department of Ophthalmology, Hacettepe University, Ankara, Turkey
⁵ Sam Rothberg Glaucoma Centre, Tel-Hashomer, Israel

Correspondence to:
Correspondence to:
Associate Professor Anastasios G P Konstas
Glaucoma Unit, "A" University Department of Ophthalmology, AHEPA Hospital, 1 Kyriakidi Str, Thessaloniki 546 36, Greece;konstas{at}med.auth.gr

Aim: To evaluate the diurnal intraocular pressure (IOP) control and safety of bimatoprost versus latanoprost in exfoliative glaucoma (XFG).

Methods: One eye of 129 consecutive patients with XFG (mean (SD) age 66.5 (8.3) years) was included in this prospective, observer-masked, three-centre, crossover comparison. After a 4–6 week medicine-free period patients were randomised to bimatoprost or latanoprost monotherapy for 3 months. Patients were then switched to the opposite treatment for another 3 months. At the end of the washout and the treatment periods diurnal IOP was measured at 0800, 1300, and 1800.

Results: At baseline the IOP (mean (SD)) was 28.0 (4.0), 26.9 (3.6), and 25.9 (3.6) mm Hg, at the three time points, respectively. Both treatments significantly reduced mean diurnal IOP at month 3. Mean diurnal IOP was 26.9 (3.5) mm Hg at baseline, 17.6 (3.3) mm Hg with bimatoprost, and 18.6 (3.6) mm Hg with latanoprost (p<0.0001). Furthermore, lower IOP values were obtained with bimatoprost at all time points (17.9 (3.4), 17.3 (3.3), and 17.6 (3.5) mm Hg, respectively) compared with latanoprost (18.7 (3.6), 18.5 (3.6), and 18.6 (4.1) mm Hg, respectively). The corresponding mean differences (0.8, 1.1, and 1.0 mm Hg, respectively) were all significant (p<0.001 for each comparison). Significantly more patients with XFG obtained a target diurnal IOP <17 mm Hg with bimatoprost than with latanoprost, 55/123 (45%) v 34/123 (28%); (p = 0.001), and significantly fewer patients were non-responders with bimatoprost than with latanoprost (5 v 13, p = 0.021). More patients reported at least one adverse event with bimatoprost than with latanoprost (58 v 41 at 3 months; p = 0.0003).

Conclusion: This crossover study suggests that better diurnal IOP control is obtained with bimatoprost than with latanoprost in patients with XFG.

Abbreviations: IOP, intraocular pressure; POAG, primary open angle glaucoma; XFG, exfoliative glaucoma

Keywords: intraocular pressure; bimatoprost; latanoprost; glaucoma

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Honrubia, F, Garcia-Sanchez, J, Polo, V, de la Casa, J M M., Soto, J (2009). Conjunctival hyperaemia with the use of latanoprost versus other prostaglandin analogues in patients with ocular hypertension or glaucoma: a meta-analysis of randomised clinical trials. Br. J. Ophthalmol. 93: 316-321 [Abstract] [Full Text]  
• Johnson, T. V., Fan, S., Camras, C. B., Toris, C. B. (2008). Aqueous Humor Dynamics in Exfoliation Syndrome. Arch Ophthalmol 126: 914-920 [Abstract] [Full Text]