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Diurnal IOP control with bimatoprost versus latanoprost in exfoliative glaucoma: a crossover, observer-masked, three-centre study
  1. A G P Konstas1,
  2. G Holló2,
  3. M Irkec4,
  4. S Tsironi3,
  5. I Durukan4,
  6. M Goldenfeld5,
  7. S Melamed5
  1. 1Glaucoma Unit, 1st University Department of Ophthalmology, AHEPA Hospital, Thessaloniki, Greece
  2. 2Department of Ophthalmology, Semmelweis University, Budapest, Hungary
  3. 3Department of Ophthalmology, Papanikolaou Hospital, Thessaloniki, Greece
  4. 4Department of Ophthalmology, Hacettepe University, Ankara, Turkey
  5. 5Sam Rothberg Glaucoma Centre, Tel-Hashomer, Israel
  1. 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

Abstract

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.

  • IOP, intraocular pressure
  • POAG, primary open angle glaucoma
  • XFG, exfoliative glaucoma
  • intraocular pressure
  • bimatoprost
  • latanoprost
  • glaucoma
  • IOP, intraocular pressure
  • POAG, primary open angle glaucoma
  • XFG, exfoliative glaucoma
  • intraocular pressure
  • bimatoprost
  • latanoprost
  • glaucoma

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Footnotes

  • Published Online First 22 November 2006

  • Sponsorship: This study was supported in part by an unrestricted grant from Allergan.

  • Competing interests: AGP Konstas is a consultant of Allergan, Alcon, Pfizer, MSD; M Irkec and S Melamed are consultants of Allergan; G Holló is a consultant of Allergan, Alcon, and Pfizer; M Goldenfeld, S Tsironi, I Durukan: none.

  • Ethics approval (see also “Methods” section): The research protocol was approved by the Institutional Review Board for Human Research of the Aristotle University of Thessaloniki, Hacettepe University and the Sam Rothberg Glaucoma Centre, Tel-Hashomer, Israel. Informed consent was obtained from all participants before they entered the study.

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