Use of latanoprost to reduce acute intraocular pressure rise following neodymium: Yag laser iridotomy

Purpose: To evaluate the efficacy of latanoprost in reducing acute intraocular pressure (IOP) elevation after neodymium:Yag laser iridotomy (LI). Methods: Primary angle-closure glaucoma (PACG) eyes were randomized to receive premedication with latanoprost and pilocarpine or with pilocarpine only before LI. Postoperative IOP changes were compared with Wilcoxon signed-ranks test using the fellow eyes of 47 patients who had one eye in each group. Results: Postoperative pressure spikes were significantly lower (p = 0.010) in the latanoprost group (4.1 ± 5.0 mmHg) than in the control group (6.7 ± 7.0 mmHg). Mean elevation of IOP was less in the latanoprost group than in the control group at 1 hour (2.5 ± 4.8 versus 4.1 ± 4.7 mmHg, p = 0.013) and 2 hours (0.8 ± 5.6 versus 4.4 ± 8.1 mmHg, p = 0.003) postoperatively. Eleven eyes in the latanoprost group (23.4%) and 20 eyes in the control group (42.6%) developed a rise in IOP ≥ 6 mmHg (p = 0.048). Conclusion: Latanoprost may reduce the pressure rise following LI in PACG eyes, but its application is limited by a late onset of effect.