The use of latanoprost 0.005% once daily and its effect on intraocular pressure as primary or adjunctive therapy

The purpose of this study was to evaluate differences in efficacy and safet y of latanoprost as monotherapy compared to adjunctive therapy in primary o pen-angle glaucoma. We reviewed records of 527 patients who were treated wi th latanoprost as mono- or adjunctive therapy to reduce the intraocular pre ssure. Each patient was treated at least three months unless they were disc ontinued due to an adverse event or lack of efficacy. In the monotherapy gr oup (n=49) baseline intraocular pressure of 2.3.6 +/- 5.2 mail Hg fell to 1 8.4 +/- 4.3 mm Hg after 4.4 +/- 2.0 months of follow-up; in the adjunctive therapy group (n=39) baseline intraocular pressure of 21.8 +/- 5.7 mm Hg fe ll to 16-.7 +/- 4.6 nim Hg following 4.3 +/- 1.8 months of therapy which wa s a similar change from baseline for both groups (P > 0.9). No differences were noted in the class or number of medicines to which latanoprost could b e added including: beta-blockers alpha-agonists and topical carbonic anhydr ase inhibitors. The reasons for failure with monotherapy were mostly advers e events (10/15 patients) and with adjunctive therapy lack of efficacy (14/ 16 patients). Latanoprost is similarly effective as monotherapy and as an a djunctive agent in reducing the intraocular pressure. Latanoprost can be ad ded successfully to a variety of classes of glaucoma medicines used commonl y as adjunctive therapy.