The Additive of Latanoprost 0.005% in Patients with Maximum Tolerated Medical Therapy Regimen

Latanoprost 0.005% which is a currently available ocular hypotensive agent has been known to produce an additional reduction of intraocular pressure when used in combination with beta adrenergic bloker. The aim of this study was to evaluate the additive effect of this drug in patients with maximum tolerated medical therapy regimen. 48 eyes of 32 patients were categorized into 2 groups as to their type of glaucomas(primary open abgle glaucoma(POAG) vs chronic angle closure glauoma(CACG), and pilocarpine use. POAG group showed 22.3, 24.8, 22.7, 21.0, 21.4% and CACG group showed 17.6, 17.1, 15.7, 17.5, 17.8% of ocular hypotensive effect at post treatment 2 weeks, 4 weeks, 3 months, 6 months, 9 to 12 months, respectively and there was no satistically significant difference between two groups. Pilocarpine using group showed 25.5, 30.5, 26.4, 23.4, 17.8% and non-using group showed 20.6, 18.9, 19.0, 18.7, 25.1% of ocular hypotensive effect at each follow up period. Conclusively, latanoprost 0.005% appeared to be a very effective drug in reducing intraocular pressure in patients with maximum tolerated medical therapy regimen without regard to their type of glaucomas, and use of parasympathomimetics.

The Relationship Between the Activity of Matrix Metalloproteinase in the Aqueous Humor and the Development of Primary Open Angle Glaucoma

To investigate whether the abnormal expression of matrix metalloproteinases(MMPs) in the aqueous humor may case the development of glaucoma, the activity of MMP in the aqueous humor of galucoma and cataract patients were measured and compared. Six primary open angle glaucoma(POAG), 2 chronic angle closureglaucoma(CACG), 2 normal tension glaucoma(NTG), and 14 cataract patients were enrolled. Aqueous humor of each patients were collected during surgery, and total protein concentration and activity of gelatinase A in the aqueous humor were measured by protein assay kit and zymography, respectively. Total protein concentration and gelatinase A activity of POAG patients were increased by 2.1 times and 3.9 times, respectively compared to those of cataract patients. However, there were no statistically significant changes in total protein concentration and gelatinase A activity of CACG and NTG patients compared to those of cataract patients. In conclusion, the development of POAG may be associated with the abnormal expression of MMP in the aqueous humor.

The Effect of Extracapsular Cataract Extraction in Patients with Chronic Angle-Closure Glaucoma combined with Cataract

14 eyes of 11 patients with chronic angle-closure glaucoma(CACG) undergoing extracapsular cataract extraction(ECCE) with posterior chamber intraocular lens(PCIOL) implantation(group 1) and 14 eyes of 12 patients without glaucoma undergoing ECCE/PCIOL(group 2) were studied to assess the effect on anterior chamber depth, anterior chamber angle, and intraocular pressure (IOP). We measured the anterior chamber depth and angle using the EAS-1000 Scheimpflug camera. Following ECCE/PCIOL in group 1, the anterior chamber depth increased 1.00 +/- 0.25mm(p=0.0001), the anterior chamber angle widened 15.36 +/- 5.61 degrees(p=0.0001), and the postoperative IOP drop of 4.7mmHg(23.9%) showed statistical significance. Group 2 showed the increase of anterior chamber depth 0.22 +/- 0.44mm(p=0.0964), the widening of anterior chamber angle 2.51 +/- 2.65 degrees(p=0.0047), and the decrease of IOP 0.9mmHg(6.2%, p=0.0933). The effects on anterior chamber depth, anterior chamber angle, and rap were statistically significant between the two groups. Based on these results, we recommend that eyes with cataract and CACG may be considered for ECCE/PCIOL implantation as a first procedure rather than combined cataract and filtering surgery.