title: Ocular symptoms and signs with preserved and preservative-free glaucoma medications.
abstract: OBJECTIVE
  To compare the prevalence of side effects between eyedrops with or without preservatives, in terms of subjective symptoms and objective signs in patients with open-angle glaucoma.
  
  
  METHODS
  In a multicenter cross-sectional epidemiologic survey in four European countries, ophthalmologists in private practice enrolled 9658 nonconsecutive patients using preservative (P) or preservative-free (PF) beta-blocking eyedrops between June 1997 and December 2003. Subjective symptoms, conjunctival and palpebral signs, and superficial punctate keratitis were explored before and after a change in therapy. For statistical analysis, a Chi-square test was used to calculate the differences in the prevalence of symptoms and signs with or without preservatives.
  
  
  RESULTS
  A total of 74% of the patients used P, 12% PF, 10% a P-PF combination, and in 4% the type of medication was unknown. Each recorded symptom and all the palpebral, conjunctival, and corneal signs were significantly more frequent (p<0.0001) in the P-group than in the PF-group, such as pain or discomfort during instillation (48 vs 19%), foreign body sensation (42 vs 15%), stinging or burning (48 vs 20%), and dry eye sensation (35 vs 16%). A total of 68% of the patients had a sec-ond visit performed, of whom 63% (6083) had been evaluated on treatment difference. A significant decrease (p<0.0001) of all ocular symptoms and signs was observed in patients in whom the preserved eyedrops were diminished in number or altered into preservative free drops.
  
  
  CONCLUSIONS
  Compared to preserved eyedrops, preservative free eyedrops are significantly less associated with ocular symptoms and signs of irritation.
authors.affiliation: UZ Sint Rafaël, Leuven, Belgium.
authors.forename: N
authors.initials: N
authors.lastname: Jaenen
authors.forename: C
authors.initials: C
authors.lastname: Baudouin
authors.forename: P
authors.initials: P
authors.lastname: Pouliquen
authors.forename: G
authors.initials: G
authors.lastname: Manni
authors.forename: A
authors.initials: A
authors.lastname: Figueiredo
authors.forename: T
authors.initials: T
authors.lastname: Zeyen
mesh_terms: D000293:Adolescent; D000319:Adrenergic beta-Antagonists / Q000009:adverse effects*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000009:adverse effects; D002648:Child; D003229:Conjunctival Diseases / Q000139:chemically induced*; D003430:Cross-Sectional Studies; D005141:Eyelid Diseases / Q000139:chemically induced*; D005260:Female; D005901:Glaucoma / Q000188:drug therapy*; D006801:Humans; D015994:Incidence; D007634:Keratitis / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000009:adverse effects; D011310:Preservatives, Pharmaceutical / Q000009:adverse effects*
chemical_list: D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents; D009883:Ophthalmic Solutions; D011310:Preservatives, Pharmaceutical