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Purpose: To evaluate the effi cacy, safety and tolerability of changing to travoprost BAK-free from prior prostaglandin therapy in patients with primary open-angle glaucoma or ocular hypertension. Design: Prospective, multi-center, historical control study. Methods: Patients treated with latanoprost or bimatoprost who needed alternative therapy due to tolerability issues were enrolled. Patients were surveyed using the Ocular Surface Disease Index (OSDI) to evaluate OSD symptoms prior to changing to travoprost BAK-free dosed once every evening. Patients were re-evaluated 3 months later. Results: In 691 patients, travoprost BAK-free demonstrated improved mean OSDI scores compared to either latanoprost or bimatoprost (p Ͻ 0.0001). Patients having any baseline OSD symptoms (n = 235) demonstrated signifi cant improvement after switching to travoprost BAK-free (p Ͻ 0.0001). In 70.2% of these patients, symptoms were reduced in severity by at least 1 level. After changing medications to travoprost BAK-free, mean intraocular pressure (IOP) was signifi cantly decreased (p Ͻ 0.0001). Overall, 72.4% preferred travoprost BAK-free (p < 0.0001, travoprost BAK-free vs prior therapy). Travoprost BAK-free demonstrated less conjunctival hyperemia than either prior therapy (p Ͻ 0.0001). Conclusions: Patients previously treated with a BAK-preserved prostaglandin analog who are changed to travoprost BAK-free have clinically and statistically signifi cant improvement in their OSD symptoms, decreased hyperemia, and equal or better IOP control.

In studies dealing with the mode of action of sulfonamides, one of the objectives is to obtain information regarding the action of drugs in the highly complex environment in vivo. It is likewise the objective of such studies to demonstrate why certain drugs are most effective against certain bacteria, and others are completely ineffective. To correlate the results of in vitro studies with those This investigation has been aided by a grant from The Josiah Macy, Jr., Foundation.