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Several prostaglandins have been demonstrated to reduce intraocular pressure (IOP) in normal, hypertensive, and glaucomatous eyes.1-3 Two different prostaglandin analogs are commercially available: unoprostone (Rescula; Ciba Vision Ophthalmics, Duluth, Ga) and latanoprost (Xalatan; Pharmacia Inc, Columbus, Ohio). We observed an inverse reaction after topical administration of both analogs.
A 29-year-old woman had retinitis pigmentosa with typical ophthalmoscopic findings, a ring scotoma, and a flat electroretinogram. Juvenile glaucoma was diagnosed at the age of 12 years. Because of the characteristic malformation of the anterior segment it was classified as Rieger syndrome. The initial IOP at the time of glaucoma detection was 50 mm Hg. Both eyes underwent Elliot operation. The left eye required an additional cryocoagulation of the ciliary body. After these operations, the IOP of the right eye was between 8 and 14 mm Hg without further medication. The IOP of the left eye was below 21 mm Hg until the patient was 26 years old. The IOP then began to increase, and a second cryocoagulation was performed. After the second cryocoagulation, the IOP varied between 0 mm Hg (without therapy) and 41 mm Hg OS (with maximum tolerated medical therapy without prostaglandin analogs). At this time visual acuity was 6/30 OD and 6/12 OS.
Ness T, Funk J. Increase of Intraocular Pressure After Topical Administration of Prostaglandin Analogs. Arch Ophthalmol. 1999;117(12):1646–1647. doi:https://doi.org/
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