Preservative-Free Low-Dose Dexamethasone for the Treatment of Chronic Ocular Surface Disease Refractory to Standard Therapy

The treatment goals for glaucoma are lowering the intraocular pressure and preservation of vision. Topical hypotensive drops are the standard form of therapy which is often associated with some symptoms of toxicity, ocular inflammation, allergy, or ocular surface disease (OSD). OSD is a common comorbidity in glaucoma patients, and its prevalence with glaucoma increases with age. Use of topical treatment could additionally increase symptoms of OSD mostly due to preservatives added to multidose medication bottles used to reduce the risk of microbial contamination. This toxicity has been particularly associated with BAK, the most commonly used preservative which damages conjunctival and corneal epithelial cells and significantly aggravates OSD symptoms. OSD adversely affects patients’ quality of life causing discomfort and problems with vision which in turn may result in noncompliance, lack of adherence, and eventually visual impairment. In the management of glaucoma patients OSD symptoms should not be overlooked. If they are present, topical glaucoma treatment should be adapted by decreasing the amount of drops instilled daily, using BAK-free or preservative-free medication and lubricants if necessary. Awareness of the presence and importance of OSD will in turn improve patients' adherence and compliance and thus ultimately the preservation of long-term vision.

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Pharmacoeconomic aspects of glaucoma therapy with prostaglandin analogues in patients with signs of ocular surface disease

Ophthalmology journal ◽

10.17816/ov2015199-103 ◽

2015 ◽

Vol 8 (1) ◽

pp. 99-103

Author(s):

Alla Vsevolodovna Rudakova

Keyword(s):

Quality Of Life ◽

Clinical Efficacy ◽

Ocular Surface ◽

Negative Impact ◽

Ocular Surface Disease ◽

Prostaglandin Analogues ◽

The Cost ◽

Ophthalmic Solutions ◽

Preservative Free

Treatment of glaucoma is prevalent in modern healthcare. The standard of care at this time in the majority of glaucoma patients is to be treated with prostaglandin analogues. The aim of the present study was to compare the cost-effectiveness and the effect on the daily quality of life of preservative-free tafluprost to benzalkonium chloride (BAK) preserved latanoprost ophthalmic solutions which are present on the Russian market. In the patients with signs of ocular surface disease. Material and methods. The cost calculation was carried out on the basis of the weighted average retail price in Moscow from March 2015. The research was carried out over a 1 yeartime period. At the assessment, we assumed that clinical efficacy of the compared drugs did not differ; but at the same time the absence of the negative impact of treatment on patients’ quality of life (QoL), assessed by COMTol questionnaire, was observed in 30 % of patients treated with BAK-preserved latanoprost and in 52 % of patients treated with preservative-free tafluprost. Results and discussion. The costs of glaucoma treatment with preservative-free tafluprost and with branded BAK-preserved latanoprost are now comparable. The cost per 1 patient without the negative impact of treatment on patients’ QoL for tafluprost (Taflotan®) was 42.6 % lower than that for branded latanoprost (Xalatan®), 72.7 % higher than that for the generic latanoprost Glaumax®, and 24.3 % higher than that for the generic latanoprost Latanomol™. The analysis of the results’ sensitivity to changes in the cost of drugs in real limits demonstrated their high reliability. When taking a decision on the reimbursement for prostaglandin analogues, one should be aware that generic latanoprost ophthalmic solutions may differ significantly from the branded drug both in physical and chemical properties as well as in clinical efficacy and safety. Conclusion. Preservative-free tafluprost and branded BAK-preserved latanoprost are characterized by comparable clinical efficacy whereas preservative-free tafluprost has better tolerability. At a comparable cost of treatment, preservative-free tafluprost has a higher cost-effectiveness. This allows recommending its inclusion in regional and federal programs for the treatment of glaucoma in patients with ocular surface disease signs.

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Evaluation of ocular surface disease symptoms and patient satisfaction in dry eye disease after 84 days of treatment with preservative‐free eye drops containing sodium hyaluronate and trehalose

Acta Ophthalmologica ◽

10.1111/j.1755-3768.2022.056 ◽

2022 ◽

Vol 100 (S267) ◽

Author(s):

Antonio Mateo‐Otobia ◽

Eduardo Del Prado Sanz ◽

Alejandro Blasco Martínez ◽

Miriam Idoipe Corta ◽

María Romero Sanz ◽

...

Keyword(s):

Patient Satisfaction ◽

Dry Eye ◽

Ocular Surface ◽

Sodium Hyaluronate ◽

Dry Eye Disease ◽

Ocular Surface Disease ◽

Eye Disease ◽

Eye Drops ◽

Disease Symptoms ◽

Preservative Free

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Ocular surface conditions in Asian glaucoma patients with existing corneal disorders switching from preserved prostaglandin analogue monotherapy to preservative-free tafluprost

Malaysian Journal of Ophthalmology ◽

10.35119/myjo.v3i3.185 ◽

2021 ◽

Vol 3 (3) ◽

pp. 109-122

Author(s):

Hsien Han Lim ◽

Thanendthire Sangapillai

Keyword(s):

Intraocular Pressure ◽

Ocular Surface ◽

Open Angle Glaucoma ◽

Ocular Surface Disease ◽

Prostaglandin Analogue ◽

Ocular Surface Disease Index ◽

Open Label ◽

Fluorescein Staining ◽

Staining Score ◽

Preservative Free

Introduction: Glaucoma medications are often preserved with agents such as benzalkonium chloride, which commonly lead to ocular surface diseases.Purpose: To investigate the effect of switching to a preservative-free prostaglandin analogue, tafluprost 0.0015% on treatment tolerability and ocular surface diseases.Study design: This was a prospective, open-label, non-randomised, observational study performed in a single hospital.Materials and methods: This study involved patients of Asian descent diagnosed with primary open-angle glaucoma and ocular hypertension (n = 28), who received preserved prostaglandin monotherapy for longer than 3 months and had a National Eye Institute ocular surface staining scale score higher than 1. Patients were switched from preserved prostaglandin monotherapy to preservative-free tafluprost 0.0015%. Patients were analysed at baseline (Visit 0), 1 month (Visit 1), and 3 months (Visit 2). The main parameter measured is the change in the fluorescein staining score at Visit 2.Results: There was a significant improvement in the fluorescein staining score, with a mean reduction score of 1.96 (standard deviation, SD = 1.53; p < 0.0001), and significant reductions in conjunctival hyperaemia (bulbar, p < 0.0001; palpebral, p < 0.05) from baseline to Visit 2. The Ocular Surface Disease Index questionnaire also showed a mean reduction of 4.14 from baseline to visit 2 (SD = 8.20; p < 0.05). The intraocular pressure and tear breakup time were maintained from baseline to Visit 2.Conclusion: Switching patients to preservative-free tafluprost 0.0015% showed significant improvements in ocular surface disease with minimal side effects and similar intraocular pressure reduction rates.

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