The treatment of glaucoma using topical preservative-free agents: an evaluation of safety and tolerability. Issue 4 (3rd April 2021)

• Record Type: Journal Article
• Authors: Konstas, Anastasios G.; Labbé, Antoine; Katsanos, Andreas; Meier-Gibbons, Frances; Irkec, Murat; Boboridis, Konstadinos G.; Holló, Gábor; García-Feijoo, Julián; Dutton, Gordon N.; Baudouin, Christophe
• Is Part Of: Expert opinion on drug safety. Volume 20:Issue 4(2021)
• Page Start: 453
• Page End: 466
• Publication Date: 2021-04-03
• Subjects: BAK -- benzalconium chloride -- dry eye -- glaucoma -- intraocular pressure -- IOP -- ocular surface -- ocular surface disease -- OSD -- preservative-free; Drugs -- Side effects -- Periodicals; Drugs -- Toxicology -- Periodicals; Chemotherapy -- Periodicals; 615.704
• DOI: 10.1080/14740338.2021.1873947
• Languages: English
• ISSNs: 1474-0338

Abstract

ABSTRACT: Introduction : Preservative-free (PF) medications represent a valuable treatment strategy in the lifelong management of glaucoma. By removing preservative toxicity, PF formulations provide tangible clinical benefits to glaucoma patients worldwide. They improve tolerability and adherence, leading to a positive impact in long-term intraocular pressure (IOP) control. Areas covered : A critical review of the subject is provided, including selected evidence on the safety and tolerability of currently available topical PF formulations. Cumulative evidence confirms that topical PF medications are at least equally efficacious to their preserved equivalents. There is convincing short-term evidence for superior tolerability and safety of PF formulations compared to preserved medications. The long-term benefits and success of PF therapy requires further elucidation. Expert opinion : Successful stepwise administration of medical therapy for glaucoma remains elusive. There is a greater risk for ocular toxicity and therapy failure with preserved topical glaucoma therapy. Currently available and emerging PF therapy options potentially optimize lifelong stepwise glaucoma therapy and may enhance outcome. To avert complications from preservatives leading to poor adherence, ideally, future antiglaucoma therapy should become 100% PF. There are still key aspects of PF therapy that warrant further investigation.