The impact of latanoprost glaucoma eyedrops with and without preservatives on the ocular surface parameters – a case series report Case series report

Abstract

Background: Preservatives and additives commonly found in ophthalmic solutions can aggravate the symptoms of dry eye disease, a condition that already affects a large percentage of the global population. These additives are also frequently present in topical medications for glaucoma, another widespread disorder impacting several millions of individuals worldwide being on a persistent anti-glaucoma therapy. With the continued aging of populations, the prevalence of both diseases is expected to rise.

Methods: Four patients diagnosed with glaucoma, who were on topical latanoprost monotherapy were switched from the preservative prescription to a preservative-free analogue. Lubricating eye drops were withdrawn 4 weeks prior and restrained from use during the 3 months observation period. Tear break-up time, interferometry, conjunctival redness, tear film osmometry, along with a dry eye disease questionnaire were performed at each timepoint to assess changes on the ocular surface condition. Standard ophthalmic examination was also performed.

Results: Conjunctival redness remained constant at all timepoints. Tear film osmolarity decreased in all patients and so did the Ocular Surface Disease Index. As for the tear break-up time and interferometry, tendencies of the results were inconclusive. Best corrected visual acuity and intraocular pressure remained stable throughout the study.

Conclusions: Preservative-free topical glaucoma therapies appear to be better tolerated and impose less burden on the ocular surface. Such formulations should be prioritized for glaucoma patients, who often require life-long treatment. Given the chronic nature of dry eye disease and the absence of regenerative options for the lacrimal and meibomian glands, preventive strategies are of critical importance.