The Efficacy of Unoprostone Isopropyl as an Adjunct to Topical β-blocker in Patients with Open Angle Glaucoma: A-6-Month Study
Yupin Leelachaikul MD*, Ataya Euswas MD*
Affiliation : * Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University
Objectives : To assess the efficacy and safety of unoprostone isopropyl as an adjunctive treatment to topical
β-blocker in patients with primary open angle glaucoma (POAG).
Study
Design : This was a prospective, open-label clinical study.
Materials and Methods : A total of 44 eyes of 22 eligible patients whose intraocular pressure (IOP) was inad-
equately controlled by topical β-blocker were enrolled. Inclusion criteria consisted of patients with primary
open angle glaucoma who either had IOP measurements > 22 mmHg while on topical β-blocker monotherapy
or had IOP measurements > 18 mmHg while on dual therapy (topical β-blocker and a second drug of a
different class which was to be discontinued prior to the study to allow washing out of its effects).
Intervention: Baseline IOP, pupil size, blood pressure and pulse rate were initially measured; the patients
were then examined at 2nd, 4th, 8th, 12th, 18th and 24th weeks of following commencement of topical unoprostone
isopropyl therapy (given twice daily).
Main outcome measures: IOP, pupil size, blood pressure and pulse rate were measured and were compared to
baseline values.
Results : In 44 eyes of 22 eligible patients, unoprostone isopropyl resulted in a statistically significant IOP
reduction of 24.6% (p < 0.02). The mean systolic blood pressure decreased from 132.79 + 22.11 mmHg (range
100-180 mmHg) at baseline to 125.77 + 18.40 mmHg (range 80-160 mmHg) at 24th week after unoprostone
isopropyl administration. This reduction was statistically significant (p = 0.002) but was unlikely to have
clinical importance. Both mean diastolic blood pressure (p = 0.344), pulse rate (p = 0.306), and pupil
diameter (p = 0.107) were not significantly affected.
Conclusion : Topical unoprostone isopropyl beneficially provides additive IOP lowering effect to topical
β-blocker in patients with primary open angle glaucoma. No serious systemic side effects were found in the
present study.
Keywords : Unoprostone isopropyl, β-blocker, Primary open angle glaucoma, Intraocular pressure
