Aim: To conduct a meta-analysis of randomized clinical trials (RCTs) in order to evaluate the development of conjunctival hyperemia after the use of latanoprost versus travoprost and bimatoprost, in patients with ocular hypertension or glaucoma.
Methods: In order to identify the potentially relevant RCTs, a systematic literature retrieval was conducted in Medline, Embase and Cochrane Controlled Trials Register (1995-April 2007) databases The outcome measure was the appearance of conjunctival hyperemia during the study. Statistical analyses included the calculation of odds ratio (OR) and its respective confidence interval, along with inter-trial statistical heterogeneity. Publication bias was evaluated through a funnel plot and a sensitivity analysis was also performed.
Results: In total, 13 RCTs involving 2,222 patients with ocular hypertension or glaucoma were included, 5 comparing latanoprost versus travoprost, 7 comparing latanoprost versus bimatoprost and 1 comparing latanoprost versus travoprost and bimatoprost. The combined results showed that latanoprost produced lower occurrance of conjunctival hyperemia than both travoprost (OR = 0.51; 95 % CI: 0.39-0.67, p < 0.0001) and bimatoprost (OR = 0.32; 95 % CI: 0.24-0.42, p < 0.0001). No significant heterogeneity was found between the included RCTs. There was no evidence of publication bias. In the sensitivity analysis performed, none of clinical trials included in this meta-analysis has an important impact in the global estimation of OR.
Conclusions: According to available data, the use of latanoprost is associated with a lower incidence of conjunctival hyperemia when compared to travoprost and bimatoprost in the treatment of patients with ocular hypertension or glaucoma.