Influence of BAK-Preserved Prostaglandin Analog Treatment on the Ocular Surface Health in Patients with Newly Diagnosed Primary Open-Angle Glaucoma

Purpose. Primary open-angle glaucoma (POAG), a chronic, degenerative optic neuropathy, requires persistent decrease of intraocular pressure so as to prevent visual impairment and blindness. However, long-term use of topical ocular medications may affect ocular surface health. Purpose of this study was to evaluate the influence of BAK-preserved prostaglandin analog treatment on the ocular surface health in patients with newly diagnosed POAG. Methods. 40 newly diagnosed POAG patients were included in this prospective study. Intraocular pressure (IOP), tear break-up time (TBUT), and ocular surface disease index (OSDI) were assessed at baseline and 3-month after starting treatment with BAK-preserved travoprost 0.004%. Results. IOP decreased in all patients from baseline to 3-month final visit (23.80 +/- 1.73 mmHg versus 16.78 +/- 1.27 mmHg; P < 0.001). Mean TBUT decreased from 11.70 +/- 1.86 seconds at baseline to 8.30 +/- 1.29 seconds at 3-month final visit (<0.001). Mean OSDI score increased from 31.63 +/- 18.48 to 44.41 +/- 16.48 (P < 0.001). Conclusions. This study showed that BAK-preserved travoprost 0.004% is an effective medication in newly diagnosed POAG patients, but its long-term use may negatively influence ocular surface health by disrupting the tear film stability. Further studies are needed to better understand the clinical effects of different preservative types and concentrations on the ocular surface.