Latanoprost for uncontrolled glaucoma in a compassionate case protocol

PURPOSE: To evaluate the ocular hypotensive response of latanoprost 0.005% administered as adjunctive therapy in patients with glaucoma who were receiving maximal tolerated medical therapy. METHODS: Consecutive patients entering a latanoprost compassionate clinical trial were enrolled at two sites. Latanoprost 0.005% was administered as a single drop between 6 and 8 PM, and all other medications were continued. Intraocular pressure was measured between 2 and 4 PM. Responders were defined as having a reduction in intraocular pressure of at least 20% from baseline. RESULTS: In 160 eyes of 160 patients, mean baseline intraocular pressure +/- SD was 23.3 +/- 6.9 mm Hg. Intraocular pressure was significantly reduced compared with baseline measurements (P <.01) with mean intraocular pressure measurement reductions of 4.1 +/- 5.2, 4.0 +/- 6.3, and 3.7 +/- 4.2 mm Hg at the 1-, 3-, and 6-month intervals, respectively. A reduction in intraocular pressure of at least 20% was observed in 64 (44.4%) of 144 patients, 46 (43.0%) of 107 patients, and 10 (32.3%) of 31 patients at the 1-, 3-, and 6-month visits, respectively. A 40% reduction in intraocular pressure was observed in 18 (12.5%) of 144 and nine (8.4%) of 107 patients at 1 and 3 months, respectively. Mean reduction in intraocular pressure was similar in the miotic and nonmiotic groups (P >.4 at all intervals). Eight patients (5.0%) developed ocular allergy or irritation necessitating cessation of latanoprost therapy. CONCLUSION: Latanoprost 0.005% may provide significant further intraocular pressure reduction in patients already receiving maximal tolerated medical therapy.