Observation Of The Effect Of Ocular Hypotensive Action Of Bimatoprost In Patients With Glaucoma Following Eye Contusion

Purpose By observing the hypotensive effect of Bimatoprost in patients with traumatic glaucoma,we try to discuss the possible mechanism of it,especially when it works efficiently in patients with high intraocular pressure who are not sensitive to other anti-glaucoma drugs or even prostaglandin analogs.Methods We retrospectively observed the change of intraocular pressure(IOP)of twelve patients with glaucoma after eye contusion who were treated with bimatoprost and other regular medications or surgeries during Sep.2014 to Mar.2017 in our department,and compared the IOP before and after the administration of Bimatoprost.Results In these twelve cases we observed,eleven of them achieved normal IOP.The IOP of them before administration of Bimatoprost is between 27-58 mm Hg,on average is 40.8mm Hg.After administration of bimatoprost for 1-4 days,The IOP is between 7-21 mm Hg,on average is 16 mm Hg.Bimatoprost achieved normal IOP by reducing 13-37 mm Hg and 24.7mm Hg on average.The reduction rate of IOP is 59.5%.Patients were observed for another 2-7 days before discharge.The IOP on the discharge day is 13-21 mm Hg and 17.8mm Hg on average.But one case failed even after administration of several different kinds of anti-glaucoma drugs,bimatoprost included,and some conventional surgeries.Finally he achieved the IOP reduction after transscleral cyclophotocoagulation.Conclusion Bimatoprost can significantly and quickly reduce the IOP of patients with glaucoma after eye contusion,and maintain the IOP in a target range,especially when other anti-glaucoma drugs failed.The possible mechanism of bimatoprost could be that it can increase the rate of extracellular matrix turnover of longitudinal ciliary muscle fibers and trabecular meshwork,relax ciliary smooth muscle cells and decrease contractility of trabecular meshwork cells,so that it can decrease the resistance of uveoscleral outflow and trabecular outflow.