You are so naive and your inability to research really shows. You really should talk to your Glaucoma Specialist about this. Here we go:
glaucoma has a ridiculous amount of science justifying treatment or treatment algorithms. Researchers conducted outstanding trials which are now known as LANDMARK studies. This collection of studies are like the Bible to a Pope, the Law to a Judge, basically they in extremely high regard. Here are Summaries of a few of them:
Early Manifest Glaucoma Trial:
Every 1 mmHg reduction matters. “Among the EMGT subjects, some had more IOP lowering than others,” said Dr. Anderson, of Bascom Palmer, “and those with the greatest IOP lowering enjoyed the most benefit.” Dr. Heijl said that he was surprised by the magnitude of the treatment effect: “Every 1 mmHg of IOP reduction was associated with a risk reduction of 10 to 13 percent, depending on the analysis.”
—reducing the risk means protecting your vision long term. The variability of IOP (Peaks and Valleys during the day) can also lead to increased risk and can cause damage. So in short...YES THAT 1 mmHg is worth it. It could be the difference between having vision when you are older or being blind.
**Goal of IOP reduction is 20% (Below) and treatment and prevent further damage
Ocular Hypertension Treatment Study: Linking IOP and Onset of Glaucoma
Key Findings
Treatment delays onset of glaucoma. A pioneer among glaucoma trials, OHTS was the first to demonstrate clearly that treating abnormally elevated intraocular pressure (IOP) with topical medications delays or prevents the onset of glaucomatous damage. A second goal of the study, said Michael A. Kass, MD, OHTS principal investigator, was to identify baseline demographic and clinical risk factors for developing primary open-angle glaucoma (POAG).
At five years, treatment with topical antiglaucoma medication decreased IOP by 20 percent and reduced the incidence of glaucoma by 60 percent compared with observation.
another, Surgical in Nature but can accomplish the same goal with meds...
Advanced Glaucoma Intervention Study: Effect of Sequence in Surgical Procedures
Key Findings
Reducing IOP slows visual field loss. One of the first studies to show that a lower mean IOP results in a reduced risk of visual field progression.
How does this all fit in.......
-your efficacy claim of Vyzulta isn’t being interpreted correctly. The data you are evaluating is 29.8% reduction with Xalatan vs 34.6% reduction—-WHAT THIS MEANS is Xalatan had a reduction of 7.8 mmHg, while Vyzulta was 9mmHg. (Remember the EMGT study before?? Accomplished with more than 1mmHg and exceeds the 20% mark!)
more numbers...On reducing mmHg Vs Xalatan
42% of Vyzulta patients had a >2 reduction
30% had a >3 reduction
19% had a >4 reduction
12% had a >5 reduction
another critical piece is keeping IOP below 18mmHg
So Vyzulta has ~69% achieve IOP at or under 18 while Xalatan was only 47%
Factor in long term use (1 year), Vyzulta reduces pressures 26.5% and kept it low (no tachyphalaxis—no lack of efficacy).
the LANDMARK endpoints are being achieved by Vyzulta and beating Xalatan in so many categories that again IT IS WORTH IT.