Relative advantages and disadvantages of four families of antiglaucoma agents as first line monotherapies
| β Blockers | Brimonidine | Latanoprost | Topical CAIs | |
|---|---|---|---|---|
| CAIs = carbonic anhydrase inhibitors | ||||
| Efficacy, cost, convenience, and tolerability: | ||||
| IOP reduction efficacy for most | +++ | ++ – +++ | ++++ | + – ++ |
| 20–25% | 20–25% | 25–30% | 15–20% | |
| Cost | + | +++ | +++ | ++ |
| Instillation frequency | 1–2 times daily | 2–3 times daily | 1 times daily | 2–3 times daily |
| Topical tolerability | +++ | ++ | ++ | + – +++ |
| Topical/local effects: | ||||
| Topical allergies | +/− | ++ | +/− | +/− |
| Preservative free preparations available | Yes | No | No | No |
| Conjunctival hyperaemia | +/− | + to ++ | + to +++ | +/− |
| Hypertrichosis | – | – | + to ++++ | – |
| Iris darkening | – | – | 0 to +++ | – |
| Systemic effects: | ||||
| Bradyarrhythmias/hypotension | +++ | – | – | – |
| Bronchoconstriction | +++ | – | – | – |
| Elevated serum lipids | ++ | – | – | – |
| Increased falls in the elderly | ++ | – | – | – |
| Apnoea in infants | +/− | +++ | – | – |
| Drowsiness/anergy/fatigue | + | + to +++ | – | +/− |
| Dry mouth | – | + to +++ | – | – |
| Uveitis/CMO | – | – | 0 to ++ | – |
| Enhancement of herpetic keratopathy | – | – | 0 to ++ | – |
| Corneal oedema | – | – | – | 0 to ++ |