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Prevalence of ocular symptoms and signs with preserved and preservative free glaucoma medication

¹ APHP Ambroise Paré Hospital, University Paris V, Ophthalmology Department, 9, avenue Charles de Gaulle, 92100 Boulogne, France
² Bretonneau University Hospital, Ophthalmology Department, 2, boulevard Tonnellé, 37044 Tours Cedex 1, France
³ Théa Laboratories, 12, rue Louis-Blériot, - ZI du Brézet, 63017 Clermont-Ferrand, Cedex 2, France
⁴ XV-XX National Hospital, University Paris V, 28, rue de Charenton, 75012 Paris, France

Correspondence to:
Correspondence to:
C Baudouin; APHP Ambroise Paré Hospital, University Paris V, Ophthalmology Department, 9, avenue Charles de Gaulle, 92100 Boulogne, France;
baudouin{at}quinze-vingts.fr

Aim: To determine the incidence of ocular toxicity of preservatives with glaucoma medications.

Methods: A prospective epidemiological survey was carried out in 1999 by 249 ophthalmologists on 4107 patients. Ocular symptoms, conjunctiva, cornea, and eyelids were assessed. A ² test was used for differences between preserved eye drops (P) and preservative free eye drops (PF).

Results: 84% patients used P, 13% received PF, and 3% a combination of P and PF eye drops. All symptoms were more prevalent with P than with PF drops (p<0.001): discomfort upon instillation (43% versus 17%), and symptoms between instillations such as burning-stinging (40% versus 22%), foreign body sensation (31% versus 14%), dry eye sensation (23% versus 14%), tearing (21% versus 14%), and eyelid itching (18% versus 10%). An increased incidence (>2 times) of ocular signs was seen with P eye drops. The prevalence of signs and symptoms was dose dependent, increasing with the number of P drops. A reduction in the symptoms and signs was observed when patients changed from P to PF eye drops (p<0.001).

Conclusions: Symptoms and signs are less prevalent when PF drops are used. Moreover, most of the adverse reactions induced by P glaucoma medication are reversible after removing preservatives.

Keywords: preservatives; glaucoma; ocular surface damage

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