Long-term use of a local preservative-free hypotensive drug in the treatment of glaucoma

Relevance The main modifiable risk factor for the development and progression of glaucoma is intraocular pressure. Local antihypertensive agents are used as initial therapy for glaucoma [1–3]. The drugs of choice are prostaglandin analogues (PGA). However, with their long-term use, such adverse events as dry eye syndrome (DES) and toxic-allergic conjunctivitis may develop. This is often due to the presence of a preservative in the drops. In such cases, preservative-free forms of drugs become an indispensable alternative [4, 5]. Objective To evaluate the hypotensive efficacy and safety of preservative-free forms of PGA in patients with newly diagnosed primary open-angle glaucoma during long-term use. Material and methods A group of 32 patients (32 eyes) was diagnosed with primary open-angle glaucoma for the first time. As a starting conservative therapy, all patients were prescribed prostaglandin analogues without preservatives with a frequency of administration once a day. A comparative assessment of the level of intraocular pressure, the state of morphofunctional parameters and the state of the ocular surface was carried out after 1 and 12 months against the background of continuous use of the drug. Results After 1 month of using the therapy, all patients showed drug-induced normalization of the intraocular pressure, a decrease from 25 ± 4 to 17 ± 3 mm Hg was noted. After 12 months of continuous use of the drug, this indicator was 16 ± 3 mm Hg. The indicators of the state of morphofunctional parameters and the state of the ocular surface did not differ significantly, remaining at the same level during the study before the start of therapy, after 1 and 12 months against the background of continuous use of drops. Conclusion The preservative-free form of prostaglandin analogues has a pronounced hypotensive effect, while not having any undesirable effects on the condition of the ocular surface during prolonged use. Keywords: glaucoma; ophthalmotonus; intraocular pressure; ocular surface