Prostaglandins: A new class of aqueous outflow agents

The prostaglandin F(2α) analog, latanoprost, has been approved for the treatment of glaucoma in the United States. This is a new class of glaucoma agents that reduces intraocular pressure by increasing uveosclera outflow. Latanoprost is well tolerated, has few side effects, and maintains its efficacy over time. It is additive to other well established glaucoma medications, including timolol, acetazolamide, epinephrine, and pilocarpine. It has the unusual side effect of darkening the iris color in some patients with concentric heterochromia. This effect seems to be a cosmetic problem only, although further investigations are needed for confirmation.