latanoprost and Pain

This study evaluated the effects of acetazolamide, latanoprost, travoprost, bimatoprost, brimonidine, brinzolamide, and timolol on pain during phacoemulsification cataract surgery.. This prospective randomized comparative study included 323 eyes of 323 patients with no history of intraocular surgery or chronic eye disease who underwent uncomplicated phacoemulsification cataract surgery and foldable intraocular lens implantation under topical anesthesia. Patients were divided into 8 groups according to the preoperative prophylactic intraocular pressure (IOP)-lowering medication. The intraoperative pain was assessed postoperatively using a visual analog pain scale. The Kruskal-Wallis test investigated the differences in the visual analog pain-scale scores of the groups, and the Mann-Whitney U test investigated the pairwise comparison of the groups.. The median visual analog pain-scale score of the group that did not receive any IOP-lowering medication was 2.0±1.89. The brimonidine group exhibited the lowest visual analog pain-scale scores, and the prostanoids, especially the bimatoprost group, demonstrated the highest visual analog pain-scale scores (median±standard deviation were 0.0±1.50 and 2.0±1.91, respectively). The median visual analog pain-scale scores of the acetazolamide, latanoprost, travoprost, brinzolamide, and timolol groups were 0.0±1.62, 2.0±1.67, 2.0±1.73, 0.0±1.66, and 1.0±1.54, respectively. A pairwise comparison using the Mann-Whitney U test with Bonferroni correction revealed significant differences between the groups of acetozolamide and travoprost (p=0.001), acetozolamide and bimatoprost (p<0.001), travoprost and brimonidine (p<0.001), bimatoprost and brimonidine (p<0.001), and bimatoprost and timolol (p=0.001).. Prophylactic application of the IOP-lowering medication may alter the pain sensation during phacoemulsification cataract surgery.

Topics: Acetazolamide; Adult; Aged; Aged, 80 and over; Amides; Antihypertensive Agents; Bimatoprost; Brimonidine Tartrate; Cataract; Cloprostenol; Combined Modality Therapy; Drug Combinations; Drug Therapy, Combination; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Latanoprost; Male; Middle Aged; Pain; Phacoemulsification; Postoperative Period; Prospective Studies; Prostaglandins F, Synthetic; Quinoxalines; Sulfonamides; Thiophenes; Timolol; Travoprost

Prospective, multicenter, randomized, double-masked trials have shown latanoprost instilled once daily to be at least as effective as and generally superior to timolol administered twice daily and to be as effective as other frequently prescribed prostaglandin analogues. This study prospectively assessed the efficacy of latanoprost monotherapy in a large cohort of treatment-naive patients with a broad range of baseline intraocular pressure (IOP) levels treated in actual clinical practice settings.. This prospective, open-label, multicenter, uncontrolled, phase IV study included treatment-naive ocular hypertension or open-angle glaucoma subjects initiating latanoprost once daily (evening). IOP levels were measured at baseline and after 1 and 3 months. The primary efficacy outcome was mean change in IOP from baseline to month 3. Analyses were stratified by baseline IOP: > or = 20 and <24 mmHg vs > or = 24 mmHg.. Efficacy analyses (intent to treat) included 572 subjects: 20 to <24 mmHg group, N = 252; > or = 24 mmHg group, N = 320. Mean baseline IOP levels were 22.2 +/- 0.9 mmHg and 26.7 +/- 2.8 mmHg, respectively. At month 3, significant IOP reductions were seen in both groups (p < 0.0001, within-group differences); reductions were smaller in the 20 to <24 mmHg group (-6.3 +/- 2.4 vs -9.2 +/- 3.7 mmHg, respectively; -28.0 +/- 10.6% vs -34.1 +/- 11.9%, respectively). An IOP reduction of > or = 30% from baseline to month 3 was noted in 48.4% and 65.6% of subjects, respectively (p < 0.0001). At month 3, targets IOPs of < or = 18 mmHg were achieved by > or = 70% of subjects in both groups. Latanoprost was well tolerated with an adverse event profile similar to that reported in the literature.. This "real world" study found once-daily latanoprost to be effective and safe in treatment-naive ocular hypertension or open-angle glaucoma patients. Patients with baseline IOP levels of 20 to <24 mmHg as well as > or = 24 mmHg benefitted from initial latanoprost therapy.. NCT00647101.

Topics: Aged; Antihypertensive Agents; Conjunctiva; Drug Administration Schedule; Eye; Female; Glaucoma, Open-Angle; Humans; Hyperemia; Instillation, Drug; Intraocular Pressure; Latanoprost; Male; Middle Aged; Ocular Hypertension; Pain; Prognosis; Prostaglandins F, Synthetic; Treatment Outcome

This study aimed to compare the safety and effect on intraocular pressure (IOP) of latanoprost given every evening versus pilocarpine/timolol maleate fixed combination (PTFC) given twice daily in patients with primary open-angle glaucoma (POAG) or ocular hypertension (OH).. Following a 6-week, medicine-free period, qualified patients were randomized for Period 1 to either placebo administered every morning and latanoprost every evening or to PTFC administered twice daily. After 8 weeks of treatment, IOP was measured at 08.00, 10.00, 16.00 and 18.00 hours. Patients were then switched to the opposite treatment and underwent a second diurnal evaluation at the end of Period 2.. Thirty-two patients completed this study. They demonstrated diurnal baseline IOP of 24.1 +/- 2.4 mmHg. Mean diurnal pressure was 16.8 +/- 2.1 mmHg on PTFC and 16.9 +/- 2.5 mmHg on latanoprost (p = 0.60). No statistical difference between treatments was observed at any individual time-point except at 10.00 hours, when the PTFC group demonstrated an IOP of 15.9 +/- 2.3 mmHg and latanoprost 16.8 +/- 2.7 mmHg (p = 0.02). There were no statistical differences between groups in unsolicited systemic or ocular adverse events (p > 0.05). However, the PTFC group showed a narrower pupil diameter (2.3 mm) than the latanoprost group (3.7 mm). Additionally, a solicited symptom survey demonstrated mild blurred vision, stinging and ocular pain with PTFC (p < 0.001).. Both PTFC and latanoprost are efficacious in reducing diurnal IOP in POAG or OH. However, PTFC may be more effective in the late morning and may have a greater incidence of mild ocular side-effects.

Topics: Aged; Drug Administration Schedule; Drug Combinations; Eye; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Latanoprost; Male; Middle Aged; Ocular Hypertension; Pain; Pilocarpine; Prostaglandins F, Synthetic; Timolol; Treatment Outcome; Vision Disorders

We compared latanoprost monotherapy therapy with timolol/ dorzolamide in patients with primary open-angle glaucoma to evaluate the effects on intraocular pressure (IOP) and occurrence of adverse events. IOP and topical side effects were evaluated at the beginning, first, and third months. Mean IOP was decreased at the third month. The most common side effect was hyperemia (43.6%). We concluded that latanoprost reduces IOP better than fixed combination and its topical side effects are tolerable.

Topics: Adult; Aged; Aged, 80 and over; Drug Therapy, Combination; Eye Color; Eyelashes; Female; Glaucoma, Open-Angle; Humans; Hyperemia; Intraocular Pressure; Latanoprost; Male; Middle Aged; Pain; Prostaglandins F, Synthetic; Pruritus; Sulfonamides; Thiophenes; Timolol