Abstract
Purpose: :
Travatan (travoprost) is a synthetic prostaglandin F2α analogue for the treatment of open angle glaucoma. Intraocular pressure (IOP) is reduced by increasing uveoscleral outflow. Travatan Z is a new formulation that replaces the preservative benzalkonium chloride (BAK) from the existing Travatan solution with SOFZIA, an ionic-buffered preservative system that is less toxic to the ocular surface as shown by Baudouin et al. McCarey and Edelhauser detected loss of epithelial tight junctions in corneas secondary to BAK. A study done by Peace et al illustrated travoprost with BAK to have equal IOP-lowering efficacy as travoprost Z. The purpose of this study is to assess the change in IOP of patients on Travatan after being switched to Travatan Z.
Methods: :
This is a retrospective chart review of 204 patients at the Hines VA Hospital with glaucoma previously on Travatan and consequently switched to Travatan Z. Three IOP measurements were attained prior to the start date of Travatan Z to calculate mean IOP on Travatan. Six week and three month IOP was measured and recorded for each eye after starting Travatan Z therapy. Primary outcome evaluated was difference in IOP on Travatan Z therapy versus mean IOP on Travatan therapy. Statistical analysis was performed using ANOVA.
Results: :
Travatan Z therapy was initiated on 204 patients. For the right eye the mean IOP was 15.78 +/- 3.46 mmHg on Travatan, 16.17 +/- 5.69 mmHg on Travatan Z at 6 weeks (p=0.39), and 15.35 +/- 3.07 mmHg on Travatan Z at 3 months (p=0.48). For the left eye the mean IOP was 15.66 +/- 3.65 mmHg on Travatan, 15.27 +/- 3.32 mmHg on Travatan Z at 6 weeks (p=0.29), and 15.08 +/- 3.46 mmHg on Travatan Z at 3 months (p=0.34).Travatan Z therapy was initiated on 116 patients, who used Travatan as monotherapy. For the right eye the mean IOP was 15.40 +/- 3.33 mmHg on Travatan, 15.30 +/- 2.54 mmHg on Travatan Z at 6 weeks (p=0.46), and 15.19 +/- 2.98 mmHg on Travatan Z at 3 months (p=0.45). For the left eye the mean IOP was 15.39 +/- 3.08 mmHg on Travatan, 16.10 +/- 2.55 mmHg on Travatan Z at 6 weeks (p=0.12), and 14.52 +/- 2.87 mmHg on Travatan Z at 3 months (p=0.20).
Conclusions: :
Response to Travatan therapy versus Travatan Z therapy was similar on patients who were using travaprost alone or concurrently with other glaucoma medications. In conclusion, according to our study, Travatan Z has similar efficacy in reducing IOP compared to Travatan. This study will be continued for 6 month data by ARVO.
Keywords: intraocular pressure • drug toxicity/drug effects