Effect of bimatoprost on patients with primary open‐angle glaucoma or ocular hypertension who are nonresponders to latanoprost or timolol

Abstract Purpose To test the efficacy of bimatoprost 0.03% in lowering intraocular pressure (IOP) in patients affected by primary open‐angle glaucoma or ocular hypertension who did not respond to treatment with latanoprost 0.005% or timolol 0.5%. Methods It was a retrospective case‐note review study with minimum 6 months follow‐up. Between May and October 2007, all patients who were not responsive to latanoprost or timolol (monotherapy) were prescribed bimatoprost. In all, 635 eyes of 330 patients (latanoprost, n=405; timolol, n=230) were included. Eligibility criteria: (1) Patients with original diagnosis of POAG, and (2) Nonresponsives‐ IOP reduction <20% on current treatment.Main outcome measure was IOP reduction. Results IOP data (mean and standard deviation) were as follows: baseline = 24.85 ± 2.05 mmHg, after latanoprost =21.23 ± 1.6 mmHg, after timolol = 21.5 ± 1.66. When switched over to bimatoprost, mean IOP =18.39 ± 2.32 mmHg. There was statistically significant reduction in the IOP on bimatoprost when compared to baseline, latanoprost, and timolol (P<0.0001). 12.34% of latanoprost and 13.04% of timolol nonresponders did not respond to bimatoprost as well. While 12.72% patients reported significant conjunctival hyperaemia, only 6.96% had to stop the drug because of it. Conclusion Bimatoprost is better in controlling intraocular pressures in those non‐responsive to latanoprost or timolol. Conjunctival hyperemia remains the most important cause of stopping the use of bimatoprost.