Ocular surface changes in glaucomatous patients treated with and without preservatives beta-blockers

Area of Science:

• Ophthalmology
• Glaucoma Management
• Ocular Surface Disease

Background:

• Glaucoma patients often use beta-blockers containing preservatives.
• Preservative-containing eye drops can cause ocular surface toxicity.
• Switching to preservative-free formulations is a potential strategy to mitigate these effects.

Purpose of the Study:

• To evaluate ocular surface changes in glaucoma patients after switching from preserved to preservative-free beta-blockers.
• To assess the impact of preservative-free timolol on ocular surface parameters and patient-reported outcomes.

Main Methods:

• Prospective, longitudinal, open-label study of 132 primary open-angle glaucoma patients.
• Patients switched from preserved beta-blockers to preservative-free 0.1% timolol.
• Evaluations included ocular surface assessment, Schirmer's test, intraocular pressure (IOP), and quality of life questionnaires at baseline and 3 months.

Main Results:

• No significant changes in IOP, blood pressure, or heart rate were observed.
• Significant improvements noted in corneal and conjunctival staining, eyelid erythema, conjunctival hyperemia, and follicular hyperplasia.
• Break-up time and Schirmer's test results improved, alongside patient-reported reduction in dryness and foreign body sensation.

Conclusions:

• Preservative-free 0.1% timolol treatment positively impacts the ocular surface in glaucoma patients.
• The switch significantly reduced signs and symptoms of dry eye, including dryness, hyperemia, and foreign body sensation.
• Treatment with preservative-free timolol improved patients' quality of life.