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Ramanjit Sihota, MD, FRCS; Rohit Saxena, MD; H. C. Agarwal, MD; Vikas Gulati, MD

Arch Ophthalmol. 2004;122:185-189.

Objective  To compare latanoprost and timolol maleate as primary therapy in 60 eyes with chronic primary angle-closure glaucoma after a laser iridotomy.

Methods  We performed a prospective, randomized, crossover study of 60 eyes of 30 patients with chronic primary angle-closure glaucoma after laser iridotomy. Patients were randomized to 2 groups: those taking latanoprost once daily or those taking timolol twice daily. Three months after treatment with the first drug, the second drug was substituted. The circadian rhythm of intraocular pressure (IOP) was recorded before the start of therapy, at 3 months, and at 7 months. The fourth month was the washout period for the first drug.

Results  The mean baseline IOP was 23.5 ± 2.1 mm Hg, which decreased by 8.2 ± 2.0 mm Hg with latanoprost (P<.001) and by 6.1 ± 1.7 mm Hg with timolol (P = .01). The decrease in IOP was greater for patients taking latanoprost (P<.001). Latanoprost was significantly more effective in eyes having morning and afternoon peaks of IOP. A total of 43 eyes (72%) of patients taking latanoprost and 26 (43%) on timolol achieved a reduction of more than 30% from baseline IOP.

Conclusion  There were greater mean and peak IOP reductions achieved with 0.005% latanoprost once daily compared with 0.5% timolol twice daily.

From the Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. The authors have no relevant financial interest in this article.

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