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Topical Prostaglandin Analogues with and without Preservatives on Tear Film Stability in the Long-Term Treatment of Glaucoma

BACKGROUND Prostaglandin analogues (PGAs) have proven to be the most potent of the antiglaucoma medications in decreasing IOP, with little systemic side effects and hence are the initial treatment of choice. Many PGAs contain preservatives which are associated with increased ocular side effects, the most common preservative being benzalkonium chloride (BAK). BAK is known to cause cell toxicity and cell death in ocular surface tissues in a dose-dependent and time-dependent manner and often gives rise to ocular surface diseases, with the consequence of dysfunctional tear film in patients who are on long-term PGA therapy. We wanted to evaluate the long-term effects of prostaglandin analogue eye drops with and without preservative on tear film stability in glaucoma patients who are instilling these medications on a long-term basis. and glaucoma were started on either of the two eye drops: Tovaxo (Travoprost 0.004%, preservative-free) and 9PM (Latanoprost 0.005%, BAK 0.02%). The patients were followed up for one year at the end of which period Tear break up times (TBUT) were measured and Schirmer’s tests were performed.