Corneal cytotoxicity of topically applied drugs, vehicles and preservatives

Burstein, Neal L.

doi:10.1016/0039-6257(80)90072-7

Cited by 200 publications

(66 citation statements)

References 79 publications

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“…1 These effects have been demonstrated in animals and humans with both in vitro and in vivo models. [2][3][4][5] Studies have also demonstrated that when comparing topical medications with preservatives and their non-preserved counterpart, there is less ocular toxicity, suggesting a direct correlation with the presence of preservative and damage to the ocular surface. [5][6][7] One of the more common preservatives used today is benzalkonium chloride (BAK).…”

mentioning

confidence: 99%

Effects of prostaglandin analog therapy on the ocular surface of glaucoma patients

Horsley

Kahook²

2009

OPTH

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Purpose: To quantify changes in tear break-up time (TBUT), corneal staining and ocular surface disease index (OSDI) in glaucoma patients after switching therapy from latanoprost with 0.02% benzalkonium chloride (BAK) to travoprost with sofZia ™ . Methods: Prospective consecutive case series evaluating patients before and 8 weeks after switching from latanoprost with BAK to travoprost with sofZia ™ in patients with baseline TBUT less than 6 seconds.Results: Forty eyes of 20 consecutive patients using latanoprost with BAK were switched to travoprost with sofZia ™ . Mean TBUT prior to starting travoprost was 2.02 ± 0.71 seconds and increased to 6.34 ± 1.31 seconds 8 weeks after the switch (p Ͻ 0.001). Mean inferior corneal staining scores decreased from 2.40 ± 0.87 to 1.38 ± 0.59 (p Ͻ 0.001). Mean OSDI scores decreased from 26.31 ± 8.25 to 16.56 ± 6.19 (p Ͻ 0.001). Discussion: This report focuses on the status of the ocular surface, as documented by TBUT, corneal staining and OSDI, in patients switched from latanoprost with BAK to travoprost without BAK. The switch resulted in a statistically signifi cant increase in TBUT and decreases in corneal staining and OSDI in patients with low baseline TBUT values. Conclusion: BAK, a common preservative for glaucoma drops, may increase OSD by disrupting the tear fi lm and increasing conjunctival infl ammation. In this study, a change from a BAK-preserved prostaglandin analog (PGA) to a non-BAK-preserved PGA resulted in a measurable improvement of TBUT, corneal staining and OSDI. Further studies are needed to better understand the impact of BAK-preserved medications on the ocular surface.

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confidence: 99%

Effects of prostaglandin analog therapy on the ocular surface of glaucoma patients

Horsley

Kahook²

2009

OPTH

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“…Benzalkonium chloride (BAK) is one of the most potent preservatives and a component of most eye drops, (Kaur et al 2009) because of its strong beneficial effect on microbacterial protection and solvent. On the other hand, BAK induces cytotoxic effects on cultured keratoconjunctival epithelial cells (Burstein 1980;De Saint Jean et al 2000;Cha et al 2004;Guenoun et al 2005;Leung et al 2008). The introduction of BAKcontaining eye drops was associated Effects of SofZia-preserved travoprost and benzalkonium chloride-preserved latanoprost on the ocular surface -a multicentre randomized single-masked study…”

Section: Introductionmentioning

confidence: 99%

Effects of SofZia‐preserved travoprost and benzalkonium chloride‐preserved latanoprost on the ocular surface – a multicentre randomized single‐masked study

Aihara

Oshima

Araie

2012

Acta Ophthalmologica

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ABSTRACT.Purpose: To assess the effect of SofZia-preserved travoprost on ocular surface conditions in comparison with benzalkonium chloride (BAK)-preserved latanoprost. Methods: A prospective randomized multicentre single-masked comparative study. Patients with open-angle glaucoma or ocular hypertension who had been treated with BAK-preserved latanoprost 0.005% (Xalatan Ò ) monotherapy for at least 3 months. Patients were enrolled at 23 facilities. Patients were randomly divided into the X-X group, continuous use of Xalatan Ò , or the X-T group, switching from Xalatan Ò to SofZia-preserved travoprost 0.004% (TravatanZ Ò ), and followed for 3 months. The superficial punctate keratopathy (SPK), conjunctival epitheliopathy, hyperaemia, tear break-up time (TBUT) and intraocular pressure (IOP) were examined for each patient in a masked manner. Changes in the frequency of keratoconjunctival epitheliopathy were evaluated 3 months after study initiation. Intra-and intergroup comparisons of changes in SPK, conjunctival epitheliopathy, hyperaemia, TBUT and IOP were also carried out. Results: Two hundred twenty patients participated and 215 completed the 3-month study. The frequency of keratoconjunctival epitheliopathy significantly decreased in the X-T group (p = 0.036) and the intergroup difference was also significant (p = 0.001). SPK scores and TBUT were significantly improved in the X-T group (p = 0.034, 0.049), also with significant intergroup differences in the cornea excluding the inferior area and TBUT. There were no significant intergroup differences in changes of the hyperaemia scores and the IOP reduction. Conclusion: Switching to SofZia-preserved travoprost after BAK-preserved latanoprost resulted in a lower incidence of keratoconjunctival epitheliopathy, especially in the cornea, with no clinically relevant changes in hyperaemia and IOP.

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“…[8] Topikal ajanlar ve içerdikleri koruyucuların toksisitesi oküler yüzey bulguları ile ortaya çıkabilse de, follikü-ler reaksiyonlar ve punktat epitelyopati bulguları ön plandadır. [9] Hepsinde batma-yanma belirtileri görüle-bilirken, şişe ucuna bağlı yaralanmalarda konjonktiva erozyonuna da rastlanılmaktadır. Erozyonun şekli de tipiktir ve haritaya benzer ve sınırları girdili çıktılıdır.…”

Section: Discussionunclassified

Mechanical ocular surface injuries caused by careless handling of topical agents

Oruçoğlu¹

2013

J Kartal TR

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Corneal cytotoxicity of topically applied drugs, vehicles and preservatives

Cited by 200 publications

References 79 publications

Effects of prostaglandin analog therapy on the ocular surface of glaucoma patients

Effects of prostaglandin analog therapy on the ocular surface of glaucoma patients

Effects of SofZia‐preserved travoprost and benzalkonium chloride‐preserved latanoprost on the ocular surface – a multicentre randomized single‐masked study

Mechanical ocular surface injuries caused by careless handling of topical agents

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