Short-term safety and efficacy of ripasudil as "add-on therapy" in glaucoma patients on maximum tolerable glaucoma medication.

Abstract

Purpose: The purpose of this study was to evaluate the additional intraocular pressure (IOP) lowering effect and tolerability of ripasudil in patients with glaucoma inadequately controlled with maximum tolerable medical therapy.

Methods: A prospective, noncomparative, interventional case series. Patients with primary open-angle glaucoma (POAG) but IOP inadequately controlled with maximum medical therapy were enrolled for this. Ripasudil (0.4%) was added as adjunctive therapy to the ongoing glaucoma treatment. The primary outcome was the mean IOP reduction after 3 months of treatment, whereas the secondary outcome was the percentage attainment of predefined target IOP and the incidence of any adverse events.

Results: A total of 42 eyes of 42 patients with POAG were evaluated. Mean number of medications at the time of enrolment was 3.54 ± 0.45. The percentage IOP reduction from baseline was 16.8% with a 95% confidence interval, mean IOP reduction was - 2.9 mm Hg (range: -1.9--4.6) with P < 0.001 after 3 months of treatment. Eighteen eyes (42.8%) were able to achieve the target IOP. Notable adverse event was conjunctival hyperemia in 57.14% and blepharitis in 2.38% of the eyes but they were mild and transient.

Conclusion: Ripasudil is effective and tolerable in POAG patients already on maximal medical therapy. It can be utilized as an extra tool that can postpone invasive procedures, especially in the short term.