Enhanced efficacy of topical latanoprost 0.005% demonstrated by corneal biomechanical correcting modified Goldmann prism
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First Author: S.McCafferty USA
Co Author(s): N. Radcliffe J. Berdahl
Evaluate intraocular pressure (IOP) reduction measured by a Goldmann applanation tonometer (GAT) prism and a modified surface Goldmann (CATS) prism with the institution of a topical prostaglandin analog (PGA) or alternatively a topical beta blocker.
Clinical prospective, open-label, randomized, controlled, reference device comparison
Seventy-two (72) treatment naïve glaucoma patients were randomized (36 in each group) to treatment with latanoprost 0.005% or timolol maleate 0.5%. Each patient underwent IOP measurement with standard GAT and CATS prisms before and at 1,3, and 6 months of treatment. Central corneal thickness (CCT) and corneal hysteresis (CH) were also measured. Medication response was defined as a 20% reduction in IOP from baseline.
The CATS prism demonstrated the IOP reduction with topical latanoprost at a mean of 2.0 mmHg lower than the IOP measured with GAT (p=0.0002). The CATS and GAT prisms detected no difference in IOP reduction with timolol(p=0.17). The number of latanoprost treatment non-responders was reduced from 36.1% measured with GAT to 13.8% when measured with the CATS prism(p=0.005). Timolol indicated no difference in the treatment non-response rate at 22.2% (p=0.999). CH increased significantly with latanoprost treatment by an average of 0.55 mmHg(p=0.014) and remained unchanged with timolol at -0.014 mmHg(p=0.68).
Improved IOP reduction and responder rates were demonstrated with a CATS prism in patients using latanoprost and not with timolol use. Latanoprost induced alterations in corneal biomechanics likely dampen the actual IOP reduction measured with a standard GAT prism and the increase in CH support these findings.
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