Prescrire Int. 1998 Dec;7(38):166-8.
(1) Latanoprost, a prostaglandin F2 alpha analogue, is an antiglaucoma drug. (2) The clinical file is fairly thorough. (3) Dose-finding studies show that the optimal daily dose is a single drop of 0.005% solution, preferably in the evening. Two drops a day are less effective than one drop a day. (4) The local hypotensive action of latanoprost persists in the long term (current follow-up one year). (5) Four double-blind trials have compared 0.005% latanoprost eye drops and 0.5% timolol eye drops. In three trials the effect of latanoprost on intraocular pressure was statistically stronger than that of timolol. However, the difference in mean intraocular pressure was less than 2 mm Hg between the two treatments, and the clinical relevance of such a difference is not known. (6) Latanoprost has not been compared with the other available antiglaucoma eye drops. (7) Various trials have shown that intraocular pressure is statistically lower when latanoprost is combined with another antiglaucoma eye drop preparation (timolol, pilocarpine or dipivefrine) than during monotherapy. The additive action of latanoprost eye drops when combined with oral acetazolamide has been established more soundly in a comparative double-blind trial. (8) In approximately 30% of cases (especially patients with non homogeneous eye colour), latanoprost eye drops can cause permanent darkening of the iris. Patients must be warned of this risk before beginning treatment.
(1) 拉坦前列素是一种前列腺素F2α类似物，是一种抗青光眼药物。(2) 临床资料相当详尽。(3) 剂量探索研究表明，最佳日剂量为一滴0.005%的溶液，最好在晚上使用。每天两滴的效果不如每天一滴。(4) 拉坦前列素的局部降压作用长期持续存在（目前随访一年）。(5) 四项双盲试验比较了0.005%拉坦前列素滴眼液和0.5%噻吗洛尔滴眼液。在三项试验中，拉坦前列素对眼压的作用在统计学上比噻吗洛尔更强。然而，两种治疗之间的平均眼压差异小于2毫米汞柱，这种差异的临床相关性尚不清楚。(6) 拉坦前列素尚未与其他现有的抗青光眼滴眼液进行比较。(7) 各种试验表明，拉坦前列素与另一种抗青光眼滴眼液制剂（噻吗洛尔、毛果芸香碱或地匹福林）联合使用时，眼压在统计学上低于单一疗法。在一项比较双盲试验中，拉坦前列素滴眼液与口服乙酰唑胺联合使用时的相加作用得到了更可靠的确立。(8) 在大约30%的病例中（尤其是眼睛颜色不均一的患者），拉坦前列素滴眼液可导致虹膜永久性变黑。在开始治疗前必须告知患者这种风险。
