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Br J Ophthalmol doi:10.1136/bjo.2006.106690

Diurnal IOP control with bimatoprost vs latanoprost in exfoliative glaucoma: a crossover observer-masked three- center study

  1. Anastasios G.P. Konstas (konstas{at}med.auth.gr),
  2. Gabor Hollo (hg{at}szem1.sote.hu),
  3. Murat Irkec (mirkec{at}isnet.net.tr),
  4. Sevasti Tsironi (stsironi{at}med.auth.gr),
  5. Ismail Durukan (mirkec{at}isnet.net.tr),
  6. Mordi Goldenfeld (melamed_shlomo{at}hotmail.com),
  7. Shlomo Melamed (melamed_shlomo{at}hotmail.com)
  1. Aristotle University, Greece
  2. Semmelweis University, Hungary
  3. Dept. Ophthalmol, Hacettepe University, Turkey
  4. Papanikolaou Hospital, Greece
  5. Dept. Ophthalmol, Hacettepe University, Turkey
  6. Goldschleger Eye Institute, Israel
  7. Goldschleger Eye Institute, Israel
    • Published Online First 23 November 2006

    Abstract

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

    Methods: One eye of 129 consecutive XFG patients (mean age: 66.5±8.3 year) was included in this prospective, observer-masked, three-centre, crossover comparison. After a 4-6 week medicine-free period patients were randomized to bimatoprost, or latanoprost monotherapy for 3 months. Patients were then switched to the opposite therapy for another 3 months. At the end of the washout and the treatment periods diurnal IOP was measured at 8.00, 13.00 and 18.00.

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

    Conclusion: This crossover study suggests that bimatoprost obtains better diurnal IOP control than latanoprost in XFG.

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