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Background: To evaluate the intraocular pressure (IOP)-lowering effect of ripasudil hydrochloride hydrate and the reasons for the discontinuation of its use in glaucomatous eyes with at least 2 ocular hypotensive medications. Design: Retrospective case series. Methods: We reviewed the medical records of 116 consecutive patients with primary open angle, secondary, or developmental glaucoma. The preand post-application IOP up to 6 months after the initiation of ripasudil application was compared after adjusted by the last observation carried forward method. Multivariate analyses were used to identify factors that could account for the IOP-lowering effect of ripasudil. The reasons for discontinuation were evaluated. Results: The median preand post-application IOP at 1, 3, and 6 months was 19.0, 17.5, 17.0, and 16.0 mmHg, respectively. IOP was significantly reduced after ripasudil application at all time points (P < 0.00001, the mixed effect model). The pre-application IOP and glaucoma type were associated with the IOP-lowering effect of ripasudil. Twenty-seven and 8 patients discontinued the application because of unsatisfactory IOP reduction and intolerable side effects, respectively. Conclusion: Ripasudil reduced IOP in some patients with multiple ocular hypotensives but was discontinued in a fraction of patients due to unsatisfactory IOP reduction and intolerable side effects. ReSeARch ARTIcle

Intraocular Pressure-Lowering Effect of Ripasudil Hydrochloride Hydrate and Reasons for Discontinuation of Use in Clinical Practice