Incidence of deepening of upper eyelid sulcus after topical use of tafluprost ophthalmic solution in Japanese patients

PURPOSE To investigate the incidence of deepening of upper eyelid sulcus (DUES) with topical use of tafluprost in Japanese glaucoma patients. METHODS This study was a prospective, open-label, non-controlled case series conducted at a single center. Thirty-six primary open-angle glaucoma Japanese patients who had no history of surgery were enrolled. The patients were prescribed 0.0015% topical tafluprost once daily to one eye that had the more severe visual field disorder, and observed during outpatient visits before and at 30, 60, and 90 days after starting treatment. At every visit, three examiners judged the presence of DUES unanimously by facial photographs including eyebrows and lower eyelids. The primary outcome variable was the incidence of DUES at the end of day 90 in the study as assessed by observer-masked facial photography. The patients were also asked if they noticed any subjective symptom of DUES. Gender, refraction, and intraocular pressure were evaluated as potential risk factors. RESULTS Thirty-two patients completed this clinical trial. DUES were identified objectively in 19% (6/32) of the patients after 90 days of treatment. The incidence was not related to gender, refraction, baseline or post-treatment intraocular pressure, or intraocular pressure reduction. Finally, 17% (1/6) of patients with objectively diagnosed DUES noticed the presence of DUES by themselves. No patient dropped out of the study because of DUES. CONCLUSION Similar to other prostaglandin analogs, topical use of tafluprost ophthalmic solution is associated with DUES as a local adverse reaction.