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

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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Comparison of Efficacy and Ocular Surface Disease Index Score between Bimatoprost, Latanoprost, Travoprost, and Tafluprost in Glaucoma Patients

Journal of Ophthalmology ◽

10.1155/2018/1319628 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7 ◽

Cited By ~ 5

Author(s):

Wissam Georges El Hajj Moussa ◽

Rebecca Georges Farhat ◽

Joseph Claud Nehme ◽

Marwan Antoun Sahyoun ◽

Alexandre Raymond Schakal ◽

...

Keyword(s):

Ocular Surface ◽

Open Angle Glaucoma ◽

Disease Index ◽

Ocular Surface Disease ◽

Newly Diagnosed ◽

Ocular Surface Disease Index ◽

Conjunctival Hyperemia ◽

Open Label ◽

Prostaglandin Analogues ◽

The Impact

Aim. The purpose of this study is to evaluate and compare the efficacy of 4 prostaglandin analogues (PGAs) and to determine the incidence of ocular surface disease in newly diagnosed, primary open-angle glaucoma (POAG) patients started on one of those 4 PGAs: bimatoprost (benzalkonium chloride, BAK, 0.3 mg/mL), latanoprost (BAK 0.2 mg/mL), travoprost (polyquad), and tafluprost (BAK-free). Patients and Methods. In this single-center, open-label trial, 32 patients newly diagnosed with POAG were randomly started on one of the four PGAs. All patients underwent a complete ophthalmological exam at presentation and at 1, 3, and 6 months of follow-up. Dry eye disease (DED) was assessed using the original Ocular Surface Disease Index (OSDI) questionnaire, in order to evaluate the impact of the drops on the quality of life of patients. Results. The mean age was 60.06 years ± 11.76. All four drugs equally and significantly reduced the intraocular pressure (IOP) with respect to the baseline IOP. There was a trend for a slightly greater reduction of IOP with bimatoprost, but the difference was not found to be statistically significant when compared to other PGAs. OSDI scores were significantly superior for travoprost (10.68 ± 5.73) compared to the other three drugs (p<0.05). Latanoprost caused the most significant eyelash growth and iris discoloration. Conjunctival hyperemia and superficial keratitis occurrence were similar in the four groups. Conclusion. All prostaglandin analogues equally and significantly reduce the IOP in patients with POAG. According to the results of the OSDI score, latanoprost seems to be the least tolerated among the four drugs.

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Comparison of ocular surface assessment and adherence between preserved and preservative-free latanoprost in glaucoma: a parallel-grouped randomized trial

Scientific Reports ◽

10.1038/s41598-021-94574-x ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Dai Woo Kim ◽

Jonghoon Shin ◽

Chang Kyu Lee ◽

Myungjin Kim ◽

Sohyeon Lee ◽

...

Keyword(s):

Free Group ◽

Ocular Surface ◽

Open Angle Glaucoma ◽

Drug Tolerance ◽

Adherence Rate ◽

Eye Drops ◽

Ocular Surface Disease Index ◽

Significant Difference ◽

Surface Assessment ◽

Preservative Free

AbstractGiven that nonadherence is related to subject characteristics and drug tolerance and preserved eye drops tend to be more intolerable than preservative-free ones, we conducted a phase 4, parallel-grouped, investigator-blind, active-control, randomized, multicenter study. A total of 51 patients with intraocular pressure (IOP) ≥ 15 mmHg diagnosed with open-angle glaucoma or ocular hypertension were randomly assigned to the preserved latanoprost group (n = 26) and the preservative-free latanoprost group (n = 25). The efficacy variables were corneal/conjunctival staining grade, Ocular Surface Disease Index (OSDI), adherence at 12 weeks after the first administration; corneal/conjunctival staining grade at 4 weeks; and IOP, tear break-up time (TBUT), and hyperemia score at 4 and 12 weeks. The safety variables included visual acuity and drug tolerance questionnaire results. There was no statistically significant difference in corneal/conjunctival staining grade, OSDI, or TBUT between the groups at 4 and 12 weeks. However, the adherence rate was higher and the hyperemia score was lower in the preservative-free group than in the preserved group. The severity and duration of stinging/burning sensation were lower in the preservative-free group than in the preserved group. Overall, preservative-free latanoprost showed better ocular tolerance assessed by hyperemia scores and stinging/burning symptoms following higher adherence than preserved latanoprost.

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

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v6i6.4093 ◽

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.

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Prospective study comparing Xalatan® eye drops and two similar generics as to the efficacy and safety profile

European Journal of Ophthalmology ◽

10.1177/1120672117747030 ◽

2018 ◽

Vol 28 (4) ◽

pp. 378-384 ◽

Cited By ~ 2

Author(s):

Andreas Diagourtas ◽

Kostantinos Kagelaris ◽

Kostantinos Oikonomakis ◽

Andreas Droulias ◽

Nikolaos Kokolakis ◽

...

Keyword(s):

Intraocular Pressure ◽

Safety Profile ◽

Ocular Surface ◽

Disease Index ◽

Ocular Surface Disease ◽

Eye Drops ◽

Efficacy And Safety ◽

Ocular Surface Disease Index ◽

Significant Difference ◽

The Mean

Purpose: To evaluate the efficacy and safety between two generic prostaglandins Lataz–Xalaprost (Greece) and the corresponding original drops (Xalatan®). Material and methods: In this prospective randomized study, 60 patients diagnosed with open-angle glaucoma or ocular hypertension were enrolled, who had never received antiglaucoma treatment. Subjects were divided randomly into three groups (Xalatan, Lataz, and Xalaprost groups) and they were studied over 16 weeks. At each visit, the mean applanation tonometry values and tear break-up time were measured. The Ocular Surface Disease Index questionnaire was used to evaluate patient’s symptoms. Results: There was a statistically significant difference (p < 0.001) in the mean values of the intraocular pressure between the baseline and the last visit (Xalatan group: from 23.11 ± 1.61 mmHg to 15.81 ± 1.22 mmHg, Lataz group: from 23.26 ± 1.33 mmHg to 15.80 ± 1.47 mmHg, and Xalaprost group: from 23.08 ± 1.45 mmHg to 16.08 ± 1.38 mmHg). Both generic eye drops showed mean percentage intraocular pressure reduction comparable to the standards of prostaglandin analogues (Xalatan: 31.57%, Lataz: 32.06%, and Xalaprost: 30.34%). Xalatan reduced the tear break-up time less, followed by Lataz and then by Xalaprost (Xalatan: from 8.5 to 8 s, Lataz: from 8.2 to 7.4 s, and Xalaprost: from 8.7 to 7.7 s). Xalatan presented the best safety profile, followed by Lataz and least was Xalaprost, according to Ocular Surface Disease Index questionnaire’s results. Conclusion: No significant difference was recorded in the effectiveness of each generic prostaglandin compared to the original. Furthermore, no patient had to change medication. The differences that arose in the safety profile of the three eye drops suggest a prompt closer initial monitoring of patients who are administered generic eye drops.

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Effects of topical low-dose preservative-free hydrocortisone on intraocular pressure in patients affected by ocular surface disease with and without glaucoma

Graefe s Archive for Clinical and Experimental Ophthalmology ◽

10.1007/s00417-021-05345-3 ◽

2021 ◽

Author(s):

M. Filippelli ◽

R. dell’Omo ◽

A. Gelso ◽

M. Rinaldi ◽

S. Bartollino ◽

...

Keyword(s):

Intraocular Pressure ◽

Ocular Surface ◽

Low Dose ◽

Ocular Surface Disease ◽

Preservative Free

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Short-term changes in ocular surface signs and symptoms after phacoemulsification

European Journal of Ophthalmology ◽

10.1177/1120672119896427 ◽

2020 ◽

Vol 30 (6) ◽

pp. 1301-1307 ◽

Cited By ~ 1

Author(s):

María García Zamora ◽

Eugenia Francés Caballero ◽

Miguel J Maldonado

Keyword(s):

Dry Eye ◽

Ocular Surface ◽

Signs And Symptoms ◽

Disease Index ◽

Ocular Surface Disease ◽

Schirmer Test ◽

Short Term ◽

Ocular Surface Disease Index ◽

Fluorescein Staining ◽

Superficial Punctate Keratopathy

Purpose: The aim of this study is to evaluate the incidence, natural course, and distribution pattern of superficial punctate keratopathy and describe the changes in signs and symptoms of dry eye after cataract surgery. Setting: The setting of this study is University Hospital Rio Hortega and Instituto Universitario de Oftalmobiología Aplicada, Valladolid, Spain. Design: This is a prospective interventional study. Materials and Methods: In total, 55 eyes of 55 different patients with no history of dry eye underwent standard phacoemulsification through a 2.75-mm-wide corneal incision. We measured tear break-up time, Schirmer test I, and tear meniscus height, and recorded the Ocular Surface Disease Index score, fluorescein staining patterns, and photo documentation of the ocular surface before and 1 day, 1 week, and 1 month postoperatively. Patients were divided into two groups (with and without superficial punctate keratopathy development, 1 day postoperatively). Results: Patients (mean age: 75.75 ± 7.27 years) showed an incidence of 76.3% of superficial punctate keratopathy at 24 h. Location predominated in the center of the cornea until a week (32.7%) and then began to prevail in the inferior quadrant (21.8%) at 1 month. All dry eye tests were significantly worse after surgery. Ocular Surface Disease Index increased from 10.98 ± 5.05 to 15.87 ± 6.57 at 24 h ( p < .001), to 12.80 ± 5.77 at 7 days ( p < .001), and to 11.09 ± 4.63 at 1 month ( p = .90). Fluorescein staining patterns got worse 24 h postoperatively with a score of 2.12 using the National Eye Institute/Industry–recommended guidelines staining grid. Average break-up time values were significantly lower at 1 day (6.61 ± 2.68),1 week (6.98 ± 2.79), and 1 month (7.05 ± 2.86) postoperatively than preoperatively (8.78 ± 2.97) ( p < .001). The mean postoperative first month Schirmer test I value (8.32 ± 3.58) was significantly lower than preoperative value (9.05 ± 3.63) ( p < .001). Conclusion: Phacoemulsification tends to induce short-term transitory ocular surface impairment manifesting as both signs and symptoms. Superficial punctate keratopathy distribution has a characteristic pattern evolution according to the postoperative time. Those patients with altered preoperative values are more likely to develop ocular surface disease and for longer time.

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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

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20173744 ◽

2017 ◽

Vol 6 (9) ◽

pp. 2199 ◽

Cited By ~ 2

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.

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

Archive of Ukrainian Ophthalmology ◽

10.22141/2309-8147.8.3.2020.220449 ◽

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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Objective ocular surface tolerance in patients with glaucoma treated with topical preserved or unpreserved prostaglandin analogues

European Journal of Ophthalmology ◽

10.1177/1120672118805877 ◽

2018 ◽

Vol 29 (6) ◽

pp. 645-653 ◽

Cited By ~ 4

Author(s):

Ammar El Ameen ◽

Guillaume Vandermeer ◽

Raoul K Khanna ◽

Pierre-Jean Pisella

Keyword(s):

Intraocular Pressure ◽

Prostaglandin Analogue ◽

Ocular Toxicity ◽

Prostaglandin Analogues ◽

Conjunctival Hyperaemia ◽

Ocular Symptoms ◽

Tear Meniscus ◽

Tear Meniscus Height ◽

Preservative Free ◽

Ocular Signs

Purpose: Preservatives in glaucoma medications have been associated with ocular toxicity. We compared ocular signs and symptoms in patients with open-angle glaucoma or ocular hypertension treated in monotherapy with preserved or preservative-free prostaglandin analogues. Methods: Observational cross-sectional clinical study in real life. 82 patients treated for at least 6 months with prostaglandin analogue were assessed for intraocular pressure, ocular symptoms and ocular signs including conjunctival hyperaemia, tear break-up time and tear meniscus height measured using objective and non-invasive methods (OCULUS Keratograph 5M). Patients presenting with symptoms of ocular toxicity with preserved prostaglandin analogues were switched to preservative-free latanoprost, and a second assessment was processed 6 months after. Results: At inclusion, 30 (36.6%) patients were treated with preservative-free latanoprost, 25 (30.5%) with preserved latanoprost, 16 (19.5%) with preserved travoprost and 11 (13.4%) with preserved bimatoprost. Patients treated with preservative-free latanoprost reported significantly less ocular symptoms upon instillation (mainly burning) and between instillations than patients treated with preserved prostaglandin analogues. The mean conjunctival hyperaemia (limbal + bulbar) was significantly lower with preservative-free latanoprost (2.08 ± 0.55) compared to preserved latanoprost (2.50 ± 0.7, p = 0.0085), preserved travoprost (2.67 ± 0.82, p = 0.0083) and preserved bimatoprost (2.68 ± 0.67, p = 0.0041). There were no relevant between-group differences in mean tear meniscus height and break-up time. Ocular symptoms and conjunctival hyperaemia improved when preserved prostaglandin analogues were switched to preservative-free latanoprost for 6 months while intraocular pressure reduction was maintained. Conclusion: Overall, this study suggests a better subjective and objective ocular tolerance when patients were treated with preservative-free latanoprost than with other preserved prostaglandin analogues monotherapy. Switching to preservative-free latanoprost maintained intraocular pressure at the same level as preservative prostaglandin analogue, but improved ocular surface tolerance.

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