Ocular preservatives: associated risks and newer options

Kaur, Indu Pal; Lal, Shruti; Rana, Cheena; Kakkar, Shilpa; Singh, Harinder

doi:10.1080/15569520902995834

Cited by 77 publications

(63 citation statements)

References 41 publications

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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).…”

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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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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“…Günümüzde antiglokomatöz ajanlar da dâhil olmak üzere, mevcut göz damlalarının %70'inin şişe içeriğinde prezervan madde olarak BAK mevcuttur. 10 Topikal solüsyonlardaki en sık kullanılan konsantrasyonu %0,01 olmakla birlikte, %0,004-0,02 arasında farklı uygulamaları da olabilmektedir. Bu maddenin antimikrobiyal özelliği deterjan etkisinden kaynaklanmaktadır.…”

Section: Discussionunclassified

The Effects of Polyquad-Preserved Travoprost, Benzalkonium Chloride-Preserved Latanoprost, Purite-Preserved Brimonidine and Preservative-Free Tafluprost on Ocular Surface: A Rabbit Ocular Surface Study

Şahin¹,

Ocakoğlu²,

Seçkin³

et al. 2017

Turkiye Klinikleri J Ophthalmol

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“…Eliminating or reducing exposure to BAK in ophthalmic solutions improves tear film stability, reduces conjunctival hyperemia, and improves dry eye symptoms. 7,[13][14][15] The present study was undertaken to examine the efficacy, safety, tolerability of BAK-free travoprost ophthalmic solution compared with BAK-preserved travoprost. The study demonstrated that the IOP-lowering efficacy was equivalent between BAK-free travoprost 0.004% and BAK-preserved travoprost 0.004%.…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

Section: Methodsmentioning

confidence: 99%

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

Jayanthi

Divyashree

Sujatha

2017

Int J Basic Clin Pharmacol

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Background: Prostaglandin analogues (PGAs) reduce intraocular pressure (IOP) in patients with primary open-angle glaucoma (POAG); however, these medications may affect the ocular surface and elicit ocular discomfort when preserved with benzalkonium chloride (BAK). Hence the above study was taken to evaluate the benefit of BAK-free formulations of travoprost. The objectives of the study were to compare the efficacy, safety of topical BAK-free travoprost 0.004% versus BAK-preserved travoprost 0.004% in patients with primary open angle glaucoma.Methods: 40 patients with POAG who fulfilled the inclusion /exclusion criteria were randomised into two groups of 20 each to receive BAK-free travoprost 0.004% or BAK-preserved travoprost once daily in the evening. Efficacy was measured in terms of reduction in IOP monitored at 4, 8 and 12 weeks from baseline. Ocular surface disease index (OSDI) questionnaire was used to assess the ocular surface symptoms. Safety was assessed by monitoring treatment emergent adverse drug reactions (ADRs).Results: Both the study medications were effective in reducing IOP when compared to baseline. Mean IOP reduction from baseline to week 12 was 11±3mmHg (p <0.001), 10.78±3.01mmHg, (p<0.001) in BAK-free travoprost and BAK-preserved travoprost groups respectively. Both produced equivalent reductions in IOP at the end of 4 (7.89±1.82 vs 7.63±2.83, p=0.72), 8 (9.94±2.75 vs10.05±2.75, p=0.90), and 12 weeks (11±3 vs10.78±3.01, p=0.82). BAK-free travoprost demonstrated significantly lower OSDI scores (15.10±3.60) compared to BAK- preserved travoprost (23.47±7.10) at 12 weeks (p <0.0001). There was no significant difference in occurrence of conjunctival hyperaemia between the study drugs (c2 = 0, df = 1, p = 1) and BAK-free travoprost was well tolerated.Conclusions: BAK-free and BAK-preserved travoprost significantly reduced IOP at 12 weeks. But, BAK- free travoprost produced significantly less ocular surface symptoms as compared to BAK- preserved travoprost. Hence it could be a favourable option in POAG patients with ocular surface disease symptoms.

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Ocular preservatives: associated risks and newer options

Cited by 77 publications

References 41 publications

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

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

The Effects of Polyquad-Preserved Travoprost, Benzalkonium Chloride-Preserved Latanoprost, Purite-Preserved Brimonidine and Preservative-Free Tafluprost on Ocular Surface: A Rabbit Ocular Surface Study

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

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