Preservative-Free Glaucoma Drops Improve IOP and Eye Health

Glaucoma is one of the three leading causes of blindness in Germany and worldwide. This neurodegenerative disease progressively damages the retinal nerve fibres, leading to irreversible vision loss. Although its pathogenesis is multifactorial, with age, genetics, and blood flow playing key roles, reducing intraocular pressure (IOP) remains the only modifiable risk factor. Therefore, effective IOP reduction is essential to prevent or at least slow down the progression of neuronal damage.

Treatment

A recent multicentre study prospectively examined 38 patients with primary open-angle glaucoma or ocular hypertension. All participants had been receiving monotherapy with latanoprost eye drops containing benzalkonium chloride (BAK) as a preservative for at least 6 weeks.

Prostaglandin analogues such as latanoprost are the standard first-line treatment for glaucoma. However, due to insufficient IOP reduction, the treatment was switched to a fixed combination of tafluprost 0.0015% (a prostaglandin analogue) and timolol 0.5% (a beta-blocker), in accordance with guidelines. Because all participants had ocular surface disease, a preservative-free formulation was used in this study.

BAK, the most common preservative in glaucoma eye drops, can cause ocular surface diseases such as corneal epithelial damage and conjunctival redness. Interestingly, BAK also acts as a penetration enhancer, promoting the penetration of active ingredients into the eye.

Researchers assessed the effectiveness of the preservative-free fixed combination of tafluprost and timolol by measuring IOP at multiple timepoints over 24 hours, before and 3 months after the switch. The mean 24-hour IOP significantly decreased from 17.8 mm Hg to 15.3 mm Hg, a 14% reduction, with a statistically significant reduction observed at all timepoints. Nighttime IOP control was greater than that during the daytime.

Ocular surface disease parameters were also assessed. Corneal fluorescein staining improved in 52.6% of the patients and worsened in 10.5%. Conjunctival hyperaemia decreased in 63.3% of patients and increased in 5.3%.

The study concluded that switching from latanoprost with BAK to a preservative-free fixed combination of tafluprost and timolol significantly lowered 24-hour IOP and improved symptoms of ocular surface disease.

This article was translated from Coliquio using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.