Experience with netarsudil 0.02% and latanoprostene bunod 0.024% as adjunctive therapy for glaucoma.

PURPOSE: To assess the effectiveness and safety of adjunctive topical netarsudil 0.02% and latanoprostene bunod 0.024% in patients with glaucoma. METHODS: A retrospective, multi-center, cohort study of patients with glaucoma treated with netarsudil 0.02% or latanoprostene bunod from five tertiary care centers. Inclusion criteria included patients with glaucoma treated with either medication as adjunctive therapy. Outcomes included mean absolute intraocular pressure (IOP) reduction and relative IOP reduction from baseline. Adverse reactions and reasons for discontinuation were reported. One-way analysis of variance, Kruskal-Wallis rank sum test, and Mann Whitney U test compared the outcomes. RESULTS: A total of 95 eyes (95 patients) on netarsudil and 41 eyes (41 patients) on latanoprostene bunod were analyzed. Mean duration of use was 54.3 ± 28 days for netarsudil and 82.9 ± 51.2 days for latanoprostene bunod. At the final visit, mean IOP reduction was 3.9 ± 4.6 mmHg (17.5 ± 6.0%) (p < 0.0001) with netarsudil and 2.9 ± 3.7 mmHg (13.6 ± 16.3%) (p < 0.0001) with latanoprostene bunod. IOP lowering did not depend on baseline number of IOP-lowering medications. The most common reason for discontinuation was non-effectiveness in both groups. CONCLUSION: Similar to monotherapy, netarsudil and latanoprostene bunod demonstrated efficacy in lowering IOP when used as adjunctive therapy.

Late-onset blebitis/endophthalmitis: incidence and outcomes with mitomycin C.

PURPOSE: To assess the outcomes of patients who had late infections after undergoing filtering surgery with mitomycin C with respect to treatment, resultant vision, and maintenance of intraocular pressure. METHODS: A retrospective review of 233 eyes that underwent trabeculectomy with mitomycin C with or without coincident cataract extraction and intraocular lens insertion from August 1993 to June 1997 was undertaken. Records were examined for postoperative infection occurring at least 6 months after filtering surgery. Age, sex, date, and type of surgery were reviewed and entered into a computerized database. RESULTS: Bleb infections occurred in 6 of 233 (2.6%) eyes that underwent mitomycin C filtering surgery. Four of these developed endophthalmitis. The average postoperative time until infection was 24.7 months. Two patients had bleb leaks, one of which progressed to endophthalmitis. On resolution of infection, all blebs remained functional, and vision returned to preblebitis acuities in 67%. CONCLUSION: Aggressive topical antibiotic therapy with daily observation may be appropriate in selected cases of late-onset blebitis and endophthalmitis. Eyes may continue to have good visual outcomes and functioning filters without need for additional surgery or hospitalization. Early recognition and appropriate management of infections may play a role in these outcomes.