Long-term Effect of BAK-free Travoprost on Ocular Surface and Intraocular Pressure in Glaucoma Patients After Transition From Latanoprost

Abstract

Treatment for 12 months with BAK-free travoprost after BAK-preserved latanoprost resulted in fewer ocular surface complications, as indicated by the reduced prevalence of SPK and decreased hyperemia, and no clinically relevant changes in IOP. BAK-free travoprost may have beneficial effects on the ocular surface while showing IOP-lowering efficacy comparable with BAK-preserved eye drops.

A phase III, randomized, clinical, crossover study to evaluate the non-inferiority of an ophthalmic solution of preservative-free latanoprost at 0.005% in patients with primary open-angle glaucoma

“…Earlier published studies have demonstrated that reductions in the frequency and severity of hyperemia can require 3-12 months to show significant differences between latanoprost with BAK and BAK-free treatments in POAG patients [12].…”

“…In addition, it is well-known that BAK-free PGAs present fewer toxic effects on the ocular surface [8,14,15]. Nevertheless, these preservative-free formulations must demonstrate their ability to maintain the efficacy described for their counterparts that contain a preservative [12,15]. PRO-067 (BAK-free latanoprost at 0.005%) with integrated preservative-free system (low density polyethylene bottle, closure system of high density polyethylene with a silicone valve system), can be used for up to 48 months without refrigeration (store at 30°C ± 2°C).…”

“…Another aspect concerns the identification of conjunctival hyperemia as the most common ocular complication associated with using PGAs [12,3]. This condition, however, is not an indicator of the toxicity of latanoprost but it is frequently due to a vasodilation effect [6,18].…”

“…BAK has been correlate with inflammation, conjunctival and corneal damage, decrease in the stability of the tear film because it contains a compound of polyquaternary ammonium that affects the cell membranes and the lipid component of the tears, resulting in dry eyes and irritation [8][9][10][11]. Given this background, treating POAG or OHT patients with a minimum of BAK-free medications should not only reduce IOP, but also decrease the appearance of the symptomatology of ocular surface disease (OSD) [12][13][14][15].…”

Efficacy and safety of topical BAK-free travoprost 0.004% versus BAK-preserved travoprost 0.004% in the treatment of primary open angle glaucoma: a comparative study at a tertiary care hospital

“…The classification of normal, mild, moderate, or severe OSD was determined on a scale from 0 to 100. OSD severity was classified as follows: normal (0-12), mild (13)(14)(15)(16)(17)(18)(19)(20)(21)(22), moderate (23-32), and severe (33-00). Global Evaluation of Overall Tolerability (GEOT) was assessed at 12 weeks.…”