A preliminary risk-benefit assessment of latanoprost and unoprostone in open-angle glaucoma and ocular hypertension

Latanoprost and unoprostone (isopropyl unoprostone) represent the first com mercially available prostaglandin analogues to be used for the treatment of glaucoma . Both compounds reduce intraocular pressure by enhancing uveoscl eral Latanoprost, when used once daily in the evening, produces a greater reduct ion in pressure than timolol. Latanoprost produces mild conjunctival hypera emia compared with timolol in some patients. Darkening of the irides has be en reported, especially in green-brown, yellow-brown and blue/grey-brown hi des. Hypertrichosis and hyperpigmentation of the eyelashes have also been d emonstrated. Although latanoprost has not been proven to cause uveitis or c ystoid macular oedema, case reports of an association exist. Latanoprost do es not produce systemic adverse effects nor does it alter routine blood ana lyses. Unoprostone, when given twice daily, produces less of 3 reduction in intrao cular pressure than timolol or latanoprost. Three times daily use may be re quired to approach the effectiveness of timolol. Unoprostone may have a sim ilar adverse effect profile to latanoprost, but may to cause more corneal e pithelial problems. Unoprostone is also not known to cause systemic adverse effects. Both agents are welcome additions to the treatment of glaucoma. H owever, additional studies and more experience are needed with each agents.