Efficacy and Adverse Effects of Topical Latanoprost with Respect to Preservative in Patients of POAG FC06-FC09
Dr. Gyanendra Kumar,
Department of Pharmacology, MLN Medical College, Allahabad, Uttar pradesh, India.
Introduction: Primary open angle glaucoma (POAG) is the most common form of Glaucoma and elevated IOP is one of the leading risk factor. It is shown that reduction in IOP slows the disease progression. Prostaglandin analogues (PGAs) demonstrated points of interest over other restorative medications and are presently the initial medication of choice. PGAs are dispensed in multi-dose bottles that contain preservative to guarantee sterility. Benzalkonium chloride (BAK, quaternary ammonium compound) is the most generally utilized preservative in ophthalmic solutions. Unfriendly Ocular impacts may occur due to regular use of these BAK containing ophthalmic preparations.
Aim: To evaluate and compare the effect of benzalkonium chloride (BAK) containing and benzalkonium chloride free latanoprost ophthalmic solution on ocular surface in patients with primary open angle glaucoma.
Materials and Methods: Forty six newly diagnosed POAG patients were included in this prospective study. Patients were randomly divided in two groups. Patients in Group1 (n=23) were treated with BAK preserved latanoprost 0.005% and patients in Group2 (n=23) were treated with BAK free latanoprost 0.005%. Intraocular pressure (IOP), hyperemia score and Tear Break Up Time (TBUT) were assessed at baseline, week 4 and 3 month after starting treatment by using the paired t-test (for intra-group comparison) and unpaired t-test (for inter-group comparison).
Results: IOP decreased in all patients from baseline to 3 month final visit (26.25±2.69 mmHg versus 16.97±1.88 mmHg; p<0.0001 for Group 1 and 25.36±1.93 mmHg versus 17.26 ±1.83 mmHg; p<0.0001 for Group 2). Hyperemia score for group1was increased (0.39±0.48 vs 0.68±0.15; p<0.012) at week 2 and statistically remained same for group 2 (0.41±0.49 vs 0.45±0.38; p=0.747) at week 2. Mean TBUT decreased from 12.00±2.22 seconds at baseline to 8.02±1.81 seconds at 3 month final visit (p<0.0001) for Group1. Mean TBUT decreased from 11.91±2.10 seconds at baseline to 11.63±1.79 seconds at 3 month final visit (p=0.192) for Group2.
Conclusion: This study showed that BAK preserved latanoprost 0.005% and BAK free are effective medication in newly diagnosed POAG patients. Long term use of BAK containing latanoprost may negatively influence ocular surface health.