travoprost and Pseudophakia

To investigate the effects of prostaglandin analogues on the blood-aqueous barrier and to evaluate the occurrence of cystoid macular edema in aphakic or pseudophakic patients with glaucoma.. In this randomized, masked-observer, 6-month clinical trial, patients with primary open-angle, pseudophakic, or aphakic glaucoma were treated once daily with bimatoprost (n = 16), latanoprost (n = 15), or travoprost (n = 17) or twice daily with unoprostone (n = 16) or lubricant drops (control group) (n = 16). Blood-aqueous barrier status, which was assessed using a laser flare meter; intraocular pressure; the occurrence of angiographic cystoid macular edema; and conjunctival hyperemia were evaluated.. Mean flare values were significantly higher in the bimatoprost, latanoprost, and travoprost groups throughout follow-up (P < .02). Four latanoprost-treated eyes, 1 bimatoprost-treated eye, and 1 travoprost-treated eye developed cystoid macular edema; all cases resolved after discontinuation of the prostaglandin analogue and treatment with topical diclofenac sodium. Mean intraocular pressure reductions after 6 months were higher for the latanoprost (26%), bimatoprost (28%), and travoprost (29%) groups than for the control (3%) and unoprostone (14%) groups (P< .05). Bimatoprost induced significantly higher hyperemia scores than latanoprost, unoprostone, and placebo (P< .01).. Bimatoprost, latanoprost, and travoprost use may lead to disruption of the blood-aqueous barrier in patients with pseudophakia and aphakia.

Topics: Aged; Amides; Antihypertensive Agents; Aphakia, Postcataract; Bimatoprost; Blood-Aqueous Barrier; Cloprostenol; Dinoprost; Female; Fluorescein Angiography; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Latanoprost; Lipids; Macular Edema; Male; Middle Aged; Prospective Studies; Prostaglandins F, Synthetic; Pseudophakia; Safety; Travoprost

The purpose of this article is to determine the association of postoperative topical prostaglandin analog (PGA) or topical beta-blocker use and the incidence of pseudophakic cystoid macular edema (CME).. This was a nested case-control study. All adult patients who underwent cataract surgery between January 1, 2006 and December 31, 2016 and who were enrolled in the PharMetrics Plus database were eligible for inclusion. The association between postoperative topical PGAs (bimatoprost, latanoprost, and travoprost/travoprost-z) or beta-blocker (betaxolol, levobunolol, and timolol) use and the incidence of pseudophakic CME was assessed by conditional logistic regression.. Five hundred eight cases and 5080 controls were included in the analyses. Incidence of pseudophakic CME was found to be statistically significantly associated with the current postoperative use of both topical PGAs [relative risk (RR), 1.86; 95% confidence interval (CI), 1.04-3.32] and topical beta-blockers (RR, 2.64; 95% CI, 1.08-6.49). Postoperative use of each of bimatoprost (RR, 2.73; 95% CI, 1.35%-5.53%) and travoprost/travoprost-z (RR, 3.16; 95% CI, 1.42-7.03) in the year before diagnosis was demonstrated to be statistically significantly associated with the incidence of pseudophakic CME. This association was not observed to be statistically significant with the postoperative use of latanoprost (RR, 1.55; 95% CI, 0.84-2.88).. To the best of our knowledge this is the largest study that has investigated the association between postoperative topical PGA or topical beta-blocker use and the incidence of pseudophakic CME. Postoperative use of both topical PGAs and topical beta-blockers was found to be associated with the incidence of pseudophakic CME.

Topics: Adrenergic beta-Antagonists; Adult; Aged; Aged, 80 and over; Bimatoprost; Case-Control Studies; Cataract; Cataract Extraction; Combined Modality Therapy; Female; Humans; Incidence; Intraocular Pressure; Latanoprost; Macular Edema; Male; Middle Aged; Postoperative Complications; Postoperative Period; Prostaglandins, Synthetic; Pseudophakia; Timolol; Travoprost

The aim of this study was to report a case of cystoid macular edema (CME) in a pseudophakic patient after switching from latanoprost to BAK-free travoprost.. This study is presented as an interventional case report.. Clinical examination showed the development of CME, proven by ocular coherence tomography, after institution of BAK-free travoprost in a patient that was previously treated with Latanoprost. Ocular signs and symptoms responded to stopping travoprost and treatment with topical prednisolone and non-steroidal anti-inflammatory medicines. The intraocular pressure was successfully controlled with brimonidine tartrate 0.15%.. CME is a known adverse effect of all prostaglandin analogs. However, our patient developed this complication after being switched from latanoprost to BAK-free travoprost. This may be due to exacerbation of a previously undiagnosed CME or to the ionic-buffered preservative system (sofZia) alone or in combination with travoprost unique to this product. It is prudent to exercise caution in the use of prostaglandin analogs and prostamides especially in high-risk eyes.

Topics: Aged, 80 and over; Anti-Inflammatory Agents, Non-Steroidal; Brimonidine Tartrate; Cloprostenol; Female; Humans; Instillation, Drug; Intraocular Pressure; Latanoprost; Macular Edema; Prednisolone; Prostaglandins F, Synthetic; Pseudophakia; Quinoxalines; Tomography, Optical Coherence; Travoprost; Treatment Outcome