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S. Ha, H. Sun, S. Park; Deep Lid Sulcus and Blepharoptosis After Treatment With Topical Travoprost and Bimatoprost. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2614.
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To report a new adverse effect (deep lid sulcus and blepharoptosis)related to treatment with travoprost and bimatoprost and tofind out the incidence and cause of this adverse effect.
We did a prospective cohort study including phenylephrine testin case of blepharoptosis by prescribing travoprost and bimatoprostto 44 and 60 glaucoma patients respectively. We tried to findout the incidence of this adverse effect in patients using thesetwo drugs and evaluated levator functions test , which performedin 25eyes of 14 patients who consented to test, to figure outthe cause of adverse effect.
3 of 44 patients (6.8%) and 16 of 60 patients (26.7%) treatedwith travoprost and bimatoprost respectively showed alterationof eyelid appearance. MRD1 increased after instillation of 2.5%phenylephrine in 33.3%(1/3 eyes) of travoprost group and 59.1%(13/22eyes) of bimatoprost group. Berke’s test results increasedafter instillation in all of travoprost group and 36.4%(8/22eyes) of bimatoprost group. MRD1 increased by 1.07mm in averageand Berke's test results increased by 1.40mm in average.
Results suggest that the topical travoprost and bimatoprostmight have activated prostanoid receptor subtypes(FP, TP, EP),which have relevance for the mode of action, in lid muscles,so can relax the Müller muscle, contract levator apponeurosisaccording to where receptor subtypes are. There could be racialand individual variabilities in distribution of FP, TP, EP receptorsubtypes , so could not be predicted who is likely to happen.We also strongly suspect that these receptor subtypes play asignificant role as vasodilator or vasoconstrictor in the smoothmuscle of ocular blood vessels.
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