Ocular surface status in glaucoma and ocular hypertension patients with existing corneal disorders switched from latanoprost 0.005% to tafluprost 0.0015%: comparison of two prostaglandin analogues with different concentrations of benzalkonium chloride

Abstract

Importance Glaucoma treatment has often been associated with adverse side‐effects from preservatives that are included in the used eye drops. Background To evaluate changes in the ocular surface and the presence of prostaglandin‐induced corneal disorders after being switched from latanoprost 0.005% to low preservative tafluprost 0.0015% ophthalmic solution. Design Single centre, prospective study. Participants Patients with primary open‐angle glaucoma or ocular hypertension that had received treatment with once daily latanoprost 0.005% ophthalmic solution for control of intraocular pressure (IOP) for 3 months, with a score of above 1 on the National Eye Institute (NEI) ocular surface staining scale. Methods Following the ≥3 month latanoprost treatment period, patients were switched to once daily low preservative tafluprost 0.0015% ophthalmic solution. Patients were followed for a minimum of 3 months. Main Outcome Measures Ocular surface changes were assessed by fluorescein staining score (NEI scale). Additional evaluations included tear break‐up time, hyperaemia score, subjective symptoms, changes in intraocular pressure and presence of adverse reactions. Results Out of 59 patients enrolled, 51 were included in the final analysis. Fluorescein staining scores at baseline, prior to treatment switch, were 6.9 ± 3.1 and 3.3 ± 2.7 at the end of the study period (change in scores was −3.6 ± 2.2 [P < 0.001]). At last follow‐up, significant improvements were observed in tear break‐up time, hyperaemia score and subjective symptoms (all P < 0.05). Conclusions and Relevance The clinical signs of ocular surface disease and subjective symptoms of dry eyes improved following the switch to low preservative tafluprost and demonstrated comparable IOP lowering effectiveness.

Pharmacokinetics, Safety, and Intraocular Pressure-Lowering Profile of Omidenepag Isopropyl, a Selective, Nonprostaglandin, Prostanoid EP2 Receptor Agonist, in Healthy Japanese and Caucasian Volunteers (Phase I Study)

“…Ocular AEs such as conjunctival hyperemia and photophobia are common side effects of current IOP-lowering medications, which occur as a result of the medication itself and the presence of tear-film-destabilizing preservatives. 2,[26][27][28] Conjunctival hyperemia and photophobia were observed in this study, but they were mild in severity and…”

Efficacy, Safety and Patient-Reported Outcomes with Preservative-Free (PF) Tafluprost or PF-Dorzolamide/Timolol Compared with Preserved Latanoprost: A Prospective Multicenter Study in Korean Glaucoma Patients with Ocular Surface Disease

“…Therefore, a randomized, controlled trial with a longer-term follow-up period would be warranted to further evaluate the comparative effects of the three treatments over an extended duration. In a previous single-center, prospective study, switching from ≥3 months of P-latanoprost to low preservative tafluprost for a minimum of 3 months was associated with significant improvements in fluorescein staining scores, tBUT, and subjective symptoms in patients with OSD [46]. In that particular study, patients were required to have a National Eye Institute (NEI) score above 1 [46], whereas the current study included patients with a corneal staining score of 3 or higher, and these differences in inclusion criteria may have contributed to differences in observed outcomes.…”

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

“…Previous switch studies conducted on Asian eyes have been retrospective studies looking at varying glaucoma diagnoses, or prospective studies involving patients switched from different classes of medications or from a specific eyedrop only. 20,21 This study has the advantage of being a prospective study specifically evaluating POAG and OH patients switching from preserved PGA class to PF tafluprost in a multiethnic Asian population. Even though most glaucoma patients can tolerate preserved PGAs, a large number of patients do suffer from OSD caused by preservatives, specifically BAK.…”