Chapter-53 An Update on Prostanoid Drugs in Glaucoma Therapy

BOOK TITLE: Surgical Techniques in Ophthalmology: Glaucoma Surgery

1. Teus Miguel A
2. Arranz-Marques Esther
Publishing Year
Author Affiliations
1. Vissum Madrid, Santa Hortensia 58, 28002 Madrid, Spain, Consultant Ophthalmologist, Universidad de Alcla Madrid, Spain, Instituto Oftalmologico De Alicante, Instituto Oftalmologico De Alicante, Alicante, Spain
2. Instituto Oftalmologico De Alicante, Avda. Denia 111, 03015, Alicante, Spain
Chapter keywords
glaucoma, optic neuropathy, ganglion cells, glaucomatous disease, ocular hypertension, topical prostanoids, angle closure glaucomas, herpetic keratitis, intraocular surgery, prostanoid drugs


Glaucoma is an acquired optic neuropathy in which destruction of ganglion cells and fibers leads to irreversible visual field loss. Glaucomatous disease is a generic term that includes a wide variety of optic neuropathies with different epidemiological characteristics. The purpose of any treatment of glaucoma is to prevent progression to visual disability, thus keeping a reasonable quality of life throughout the patient’s life. Nowadays, IOP reduction is the established treatment for glaucoma as it decreases the risk of progression to glaucoma in patients with ocular hypertension, and slows down, or even stops, the rate of progression of glaucomatous optic neuropathy. Historical background is presented. Topical prostanoids are now considered to be first-line antiglaucoma drugs, and they are widely used in most open angle and angle closure glaucomas, although caution is recommended in patients with previous episodes of anterior uveitis, herpetic keratitis, CME risk, or in the early period after intraocular surgery. Mechanism of action and side effects are explained. Prostanoid drugs are one of the most important classes of drugs used today for glaucoma. Their safety profile, especially from the systemic point of view, and their hypotensive strength make these drugs the mainstay of glaucoma therapy.

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