Short-term comparative study of the effects of preserved and unpreserved topical levofloxacin on the human ocular surface

Purpose: To compare the short-term effects of preserved and unpreserved topical levofloxacin on the ocular surface of preoperative patients with age-related cataracts. Methods: This was a prospective, randomized, double-blind, parallel-group study. Patients who were going to undergo cataract surgery received either preserved topical levofloxacin (with 0.01% benzododecinium bromide [BOB]) or unpreserved topical levofloxacin instilled 4 times per day in a short-term course preoperatively. Enzyme-linked immunosorbent assay (ELISA) for MUC5AC, symptom scoring, tear film break-up time (BUT), corneal fluorescein staining, Schirmer I test, and conjunctival impression cytology were performed before and after the medication. Results: Sixty-two patients (62 eyes) who completed the final evaluation were included in the data analysis. Before the medication, there was no statistically significant difference (p > .05) between the 2 groups in terms of all the subjective symptoms and objective tests. After the medication, no statistically significant difference (p > .05) was observed in the scoring of each symptom between the 2 groups. With regard to BUT, corneal fluorescein staining, Schirmer I test, and conjunctival impression cytology, the 2 groups also demonstrated similar results and showed no significant difference (p > .05). In addition, the amounts of MUC5AC in the tear samples of patients with preexisting BUT < 5 seconds were similar in the 2 groups and no significant difference was found (p > .05). Conclusion: Regarding the short-term effects on the ocular surface of patients with age-related cataracts, no clinically and statistically significant differences were observed between topical levofloxacin preserved with BOB and its unpreserved counterpart.