scholarly journals 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

2017 ◽  
Vol 6 (9) ◽  
pp. 2199 ◽  
Author(s):  
Jayanthi C. R. ◽  
Divyashree R. N. ◽  
Sujatha B. L.
Keyword(s):  
Ocular Surface ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Tertiary Care ◽  
Ocular Surface Disease ◽  
Care Hospital ◽  
Open Angle ◽  
Ocular Surface Disease Index ◽  
Significant Difference ◽  
Monitoring Treatment

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.

scholarly journals OCULAR SURFACE DISEASE AMONG PATIENTS WITH OPEN ANGLE GLAUCOMA USING TOPICAL ANTI-GLAUCOMA MEDICATIONS

2021 ◽  
Vol 71 (6) ◽  
pp. 2041-44
Author(s):  
Hassaan Javaid ◽  
Omar Zafar ◽  
Seemal Akram ◽  
Sana Abbas ◽  
Ikram Ullah Khan ◽  
...  
Keyword(s):  
Ocular Surface ◽  
Open Angle Glaucoma ◽  
Tertiary Care ◽  
Armed Forces ◽  
Disease Index ◽  
Ocular Surface Disease ◽  
Common Finding ◽  
P Value ◽  
Open Angle ◽  
Ocular Surface Disease Index

Objective: To determine the frequency of ocular surface disease among patients with open angle glaucoma using topical antiglaucoma medications presenting at a tertiary care eye hospital. Study Design: Cross-sectional analytical study. Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi, from May 2019 to Jan 2020. Methodology: One hundred and eighty patients aged 18 or more, with open angle glaucoma using any of the topical antiglaucoma medications including preparations of dorzolamide, brimonidine, timolol, levobunolol, betaxolol, latanoprost, travoprost, bimatoprost or a combination of these for more than six months took part in the study. Ocular surface disease index was used to assess the presence and severity of ocular surface disease. Results: Out of 180 patients of glaucoma managed with topical anti-glaucoma medications, 83 (46.1%) did not show presence of ocular surface disease when ocular surface disease index was administered. Twenty-nine (16.1%) patients had mild symptoms, 17 (9.4%) had moderate symptoms while 51 (28.3%) patients reported severe symptoms of ocular surface disease. Advancing age and longer duration of treatment with topical anti-glaucoma medications had statistically significant association with the presence of ocular surface disease (p-value <0.05). Conclusion: Presence of ocular surface disease was a common finding among patients using topical agents for the management of glaucoma. Advancing age and prolonged use of anti-glaucoma medication emerged as risk factors statistically related to the presence of ocular surface disease.

scholarly journals A comparative study of benzalkonium chloride-free latanoprost versus benzalkonium chloride-preserved latanoprost on ocular surface health in patients of primary open angle glaucoma

2017 ◽  
Vol 6 (5) ◽  
pp. 1110 ◽  
Author(s):  
Hema Chhabra ◽  
Anita Gupta ◽  
Gursatinder Singh
Keyword(s):  
Ocular Surface ◽  
Benzalkonium Chloride ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Tear Film ◽  
Ocular Surface Disease ◽  
Open Angle ◽  
Schirmer Test ◽  
Break Up ◽  
Ocular Surface Health

Background: Prolonged use of anti-glaucoma therapy leads to development of ocular surface disease (OSD). The purpose of this study was to compare the effect of Benzalkonium chloride (BKC)-free latanoprost and Benzalkonium chloride (BKC)-preserved latanoprost on ocular surface health in patients of primary open angle glaucoma (POAG).Methods: This was a prospective, open-label, randomized, interventional, switch trial. 30 established cases of POAG who were already on BKC-preserved latanoprost for atleast more than three months were enrolled. Their Schirmer test and Tear film break-up time (TBUT) were recorded at the baseline. They were required to answer an ocular surface disease index (OSDI) questionnaire from which an OSDI score was calculated. They were switched to BKC-free latanoprost for another three months. On their follow-up visit at 6 weeks and 12 weeks, Schirmer test and Tear film break up time were performed again and OSDI score was calculated.Results: Schirmer test increased from 6.73±3.77 mm at baseline to 9.53±3.67 mm at 6 weeks and 11.97±3.53 mm at 12 weeks (p=0.001). Mean TBUT improved significantly from 6.77±3.82 seconds at baseline to 8.63±3.91 seconds at 6 weeks to 10.47±3.76 seconds at 12 weeks (p=0.001). OSDI score decreased from 31.55±23.32 at baseline to 23.42±21.93 at 6 weeks to 15.82±20.10 at 12 weeks (p=0.001).Conclusions: BKC-free latanoprost led to improvement in tear film status or ocular surface health of glaucoma patients as compared to BKC-preserved latanoprost.

scholarly journals Outcome of Conventional Trabeculectomy in Terms of Intraocular Pressure and Visual Acuity in Primary Open Angle Glaucoma

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Erum Shahid ◽  
Uzma Fasih ◽  
Arshad Shaikh
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Primary Open Angle Glaucoma ◽  
Tertiary Care Hospital ◽  
Open Angle Glaucoma ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
Open Angle ◽  
Retrobulbar Anaesthesia

Purpose:  To determine the outcomes of conventional trabeculectomy in terms of decrease in Intra Ocular Pressure (IOP) and improvement in visual acuity in patients of primary open glaucoma, coming to a tertiary care hospital. Study Design:  Retrospective case series. Place and Duration of Study:  Ophthalmology department of a tertiary care hospital from January 2017 to December 2018. Methods:  Patients undergoing trabeculectomy for Primary open angle glaucoma were included. Patients with repeated trabeculectomy, failed argon laser trabeculoplasty, advance cataract, corneal opacities and absolute glaucoma were excluded. All the trabeculectomies were done under retrobulbar anaesthesia after taking all aseptic measures. Primary outcome measures were preoperative and postoperative visual acuity, intraocular pressure, number of antiglaucoma medications and failed or successful trabeculectomy. Results:  Total 52 patients underwent trabeculectomy. There were 36 (69.2%) males and 16 (30.8%) females. Mean age was 56.73 years ± 10.9 SD. Mean preoperative IOP was 30.96 ± 6.71 mm Hg, post operatively IOP at 1 year it was 15.6 ± 4.2 mm Hg. P value was <.000. Mean number of antiglaucoma medications was 3.03 and 1.19, pre and post-operatively respectively (p value <.000). Improvement in visual acuity after trabeculectomy was seen in 32 (61.5%) patients. Complete Surgical success was seen in 28 (53.8%) and qualified success in 21 (40.4%) patients. Failed trabeculectomy was seen in 3 (5.8%) patients. Conclusion:  Conventional trabeculectomy is effective in lowering IOP in primary open angle glaucoma patients. It maintains IOP within normal range with and without anti-glaucoma medications at 1 year follow-up. Trabeculectomy significantly reduces number of anti-glaucoma medications. Key Words:  Intraocular pressure, Primary open angle glaucoma, Trabeculectomy.

scholarly journals Prescribing trends of anti glaucoma medication usage in treatment naive patients of primary open angle glaucoma in a tertiary care hospital in Eastern India

2018 ◽  
Vol 7 (5) ◽  
pp. 971
Author(s):  
Aditi Maitra ◽  
Shashwat Bhattacharyya ◽  
Shatavisha Mukherjee ◽  
Nikhil Era ◽  
Sambuddha Ghosh ◽  
...  
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Treatment Guidelines ◽  
Open Angle Glaucoma ◽  
Tertiary Care ◽  
Fixed Dose ◽  
Care Hospital ◽  
Open Angle ◽  
Entire Study ◽  
Prescribing Trends ◽  
Treatment Naïve

Background: Primary open angle glaucoma remains a high magnitude healthcare problem due to its prevalence and chronicity. The real world scenario of anti glaucoma medical therapy needs periodical auditing as far as drug prescriptions are concerned for formulation of treatment guidelines. Few studies from India have taken a longitudinal approach in this respect. This study was undertaken to identify such lacunae.Methods: This was an open label, prospective, observational study. Each treatment naive patient was followed up for a period of 6 months, where their prescriptions were scanned for the type of the anti glaucoma medications, total number of medications, route of administration, their duration of use and their frequency of dosage and change in medications if any, in each visits.Results: A gradual shift from monotherapy towards combination therapy was observed. Overall averages for prescriptions were topped by monotherapy at 44.25 followed by fixed dose combinations at 38.25, and then combination-polytherapy at 36 and the least number of prescriptions were for concurrent polytherapy at 17.5. Amongst all monotherapy agents, beta blockers were the most frequently prescribed drugs at baseline but their share of prescriptions was almost halved at the end of our study. The prostaglandin analogs on the other hand saw an upsurge in prescriptions from their baseline to the end of this study. Prostaglandin analogs andbeta blockers as fixed dose combination was a popular prescription over the entire study duration.Conclusions: Prescribing trends were remarkable for the shift from primary monotherapy towards fixed dose combinations as the study concluded. The decline in the number of beta blocker prescriptions and a rise in prostaglandin analog prescriptions is a testament to their better effectiveness and tolerability. The future of open angle glaucoma pharmacotherapy lies in prescribing more efficacious drugs either in monotherapy or in fixed combinations.

scholarly journals To the question of the advantages of using a preservative-free form of F2 alpha prostaglandins in patients with primary open-angle glaucoma

2021 ◽  
Vol 8 (3) ◽  
pp. 13-18
Author(s):  
P.A. Bezdetko ◽  
N.V. Bezdetko ◽  
E.P. Muzhichuk
Keyword(s):  
Ocular Surface ◽  
Primary Open Angle Glaucoma ◽  
Antihypertensive Drugs ◽  
Open Angle Glaucoma ◽  
Pressure Control ◽  
Free Form ◽  
Open Angle ◽  
Ocular Surface Disease Index ◽  
Drug Free ◽  
Preservative Free

There are at least 4 reasons for choosing synthetic prostaglandins as the first-line drugs in glaucoma patients: efficacy, stable 24-hour intraocular pressure control, safety and compliance. Such qualities of these antihypertensive drugs are attracting the attention of ophthalmologists around the world. The use of synthetic prostaglandins is also associated with side effects such as eye irritation. One of the ways to solve this problem is to create a preservative-free form of the drug, free of benzalkonium chloride, including latanoprost. Our 10-week studies have convincingly shown that the use of a preservative-free form of latanoprost (monoprost) allows you to be gentle to the ocular surface, to improve the tolerance of the drug by almost 26.7–37.0 % on the Ocular Surface Disease Index. The use of a preservative-free form of latanoprost (monoprost) in patients with primary open-angle glaucoma increases the hypotensive efficacy of the drug by 9.4–15.4 % in comparison with classical latanoprost.

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