Blood-aqueous barrier changes after the use of prostaglandin analogues in patients with pseudophakia and aphakia: a 6-month randomized trial.
OBJECTIVE
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.


METHODS
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.


RESULTS
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).


CONCLUSIONS
Bimatoprost, latanoprost, and travoprost use may lead to disruption of the blood-aqueous barrier in patients with pseudophakia and aphakia.
Arcieri
Enyr S
ES
Glaucoma Service, Department of Ophthalmology, University of Campinas, Campinas, São Paulo, Brazil. rsaran@triang.com.br
Santana
Alessandro
A
Rocha
Fabiano N
FN
Guapo
Gustavo L
GL
Costa
Vital P
VP
D000368:Aged; D000577:Amides; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001036:Aphakia, Postcataract / Q000150:complications / Q000188:drug therapy*; D000069580:Bimatoprost; D018916:Blood-Aqueous Barrier / Q000187:drug effects*; D003008:Cloprostenol / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D015237:Dinoprost / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D005451:Fluorescein Angiography; D005902:Glaucoma, Open-Angle / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D000077338:Latanoprost; D008055:Lipids / Q000009:adverse effects / Q000627:therapeutic use; D008269:Macular Edema / Q000139:chemically induced / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011461:Prostaglandins F, Synthetic / Q000009:adverse effects / Q000627:therapeutic use*; D019591:Pseudophakia / Q000150:complications / Q000188:drug therapy*; D012449:Safety; D000069557:Travoprost
D000577:Amides; D000959:Antihypertensive Agents; D008055:Lipids; D011461:Prostaglandins F, Synthetic; D003008:Cloprostenol; C072630:isopropyl unoprostone; D000077338:Latanoprost; D015237:Dinoprost; D000069580:Bimatoprost; D000069557:Travoprost