Effects of SofZia‐preserved travoprost and benzalkonium chloride‐preserved latanoprost on the ocular surface – a multicentre randomized single‐masked study

Abstract

ABSTRACT.Purpose: To assess the effect of SofZia-preserved travoprost on ocular surface conditions in comparison with benzalkonium chloride (BAK)-preserved latanoprost. Methods: A prospective randomized multicentre single-masked comparative study. Patients with open-angle glaucoma or ocular hypertension who had been treated with BAK-preserved latanoprost 0.005% (Xalatan Ò ) monotherapy for at least 3 months. Patients were enrolled at 23 facilities. Patients were randomly divided into the X-X group, continuous use of Xalatan Ò , or the X-T group, switching from Xalatan Ò to SofZia-preserved travoprost 0.004% (TravatanZ Ò ), and followed for 3 months. The superficial punctate keratopathy (SPK), conjunctival epitheliopathy, hyperaemia, tear break-up time (TBUT) and intraocular pressure (IOP) were examined for each patient in a masked manner. Changes in the frequency of keratoconjunctival epitheliopathy were evaluated 3 months after study initiation. Intra-and intergroup comparisons of changes in SPK, conjunctival epitheliopathy, hyperaemia, TBUT and IOP were also carried out. Results: Two hundred twenty patients participated and 215 completed the 3-month study. The frequency of keratoconjunctival epitheliopathy significantly decreased in the X-T group (p = 0.036) and the intergroup difference was also significant (p = 0.001). SPK scores and TBUT were significantly improved in the X-T group (p = 0.034, 0.049), also with significant intergroup differences in the cornea excluding the inferior area and TBUT. There were no significant intergroup differences in changes of the hyperaemia scores and the IOP reduction. Conclusion: Switching to SofZia-preserved travoprost after BAK-preserved latanoprost resulted in a lower incidence of keratoconjunctival epitheliopathy, especially in the cornea, with no clinically relevant changes in hyperaemia and IOP.

Comparison of Corneal Safety and Intraocular Pressure–Lowering Effect of Tafluprost Ophthalmic Solution with Other Prostaglandin Ophthalmic Solutions

“…There have been reports that sofZia Ò -containing travoprost has a superior safety profile for the ocular surface compared with BAK-containing latanoprost. [15][16][17][18] However, the present study showed that BAK-reduced tafluprost caused less corneal injury than travoprost, thereby indicating that the adverse effects of BAK on the cornea can be alleviated by lowering its concentration, while maintaining its effectiveness as a preservative. In the present study, tafluprost showed better corneal safety than travoprost, which could be attributed to their different cytotoxicities against corneal epithelial cells.…”

Conjunctival matrix metalloproteinases and their inhibitors in glaucoma patients

“…This toxicity may be the reason for increased expressions of MMPs and TIMPs in the epithelium of glaucoma patients. Further, switching antiglaucoma medication to eye drops that contain a different preservative (Aihara et al 2013) or to preservative-free solutions (Mastropasqua et al 2013;Frezzotti et al 2014) might be beneficial for the maintenance of tissue integrity and health in the superficial parts of the eye. Thus, in addition to long-term treatment with multiple different eye drops, the preservative BAK itself may contribute to our results.…”

Comparison of the Toxicity Profile of Benzalkonium Chloride-Preserved Tafluprost and SofZia-Preserved Travoprost Applied to the Ocular Surface

“…Previous studies reported no significant difference of those prostaglandin drops with and without BAK. 16,24,25 A meta-analysis recently reported that latanoprost is associated with a lower incidence of conjunctival hyperemia than bimatoprost and travoprost in the treatment of ocular hypertension and/or glaucoma. 26 The reason for the reduction in hyperemia caused by latanoprost is likely due to the structure of the latanoprost molecule and its pharmacological receptor profile.…”

“…Some researchers have reported that travoprost preserved with SofZia is less toxic to the ocular surface than latanoprost preserved with 0.02% BAK. 10,[13][14][15][16] Tafluprost is also a prostaglandin F2a analog containing 0.001% BAK. BAK is not a chemical with a single structure, but rather a mixture of dodecyl, tetradecyl, and hexadecyl dimethylbenzylammonium chloride.…”