title: Long-term effect of BAK-free travoprost on ocular surface and intraocular pressure in glaucoma patients after transition from latanoprost.
abstract: OBJECTIVE
  To assess the efficacy and tolerability of benzalkonium chloride (BAK)-free travoprost after transition from BAK-preserved latanoprost.
  
  
  METHODS
  This was a prospective, open-label, multicenter study in patients with open-angle glaucoma or ocular hypertension who had been treated with latanoprost monotherapy for at least 3 months. The main outcome measures were superficial punctate keratopathy (SPK), hyperemia, and intraocular pressure (IOP). At baseline, 1, 3, and 12 months, hyperemia, SPK, and IOP were consecutively assessed. Hyperemia was assessed using a 4-grade scale. SPK was assessed by fluorescence staining observed by Area-Density classification. The IOP was measured by Goldmann applanation tonometry.
  
  
  RESULTS
  One hundred and fourteen patients participated in this study. Twenty-eight patients discontinued medications by 1 month. Sixty-seven patients completed the study. Transition from latanoprost to BAK-free travoprost showed no significant effect on hyperemia at 1 month, but showed significant decreases at 3 and 12 months compared with baseline (P<0.05). The prevalence of SPK, especially its severity score, at all points were significantly reduced compared with baseline (P<0.05). The IOP at baseline and at 12 months after transition was 14.9±3.4 and 14.3±3.3 mm Hg, indicating a significant reduction after the change in regimen compared with baseline (P<0.05).
  
  
  CONCLUSIONS
  Treatment for 12 months with BAK-free travoprost after BAK-preserved latanoprost resulted in fewer ocular surface complications, as indicated by the reduced prevalence of SPK and decreased hyperemia, and no clinically relevant changes in IOP. BAK-free travoprost may have beneficial effects on the ocular surface while showing IOP-lowering efficacy comparable with BAK-preserved eye drops.
authors.affiliation: Department of Ophthalmology, University of Tokyo, Graduate School of Medicine, Hongo Bunlyo-ku, Japan. aihara-tky@umin.ac.jp
authors.forename: Makoto
authors.initials: M
authors.lastname: Aihara
authors.forename: Shin-ichiro
authors.initials: S
authors.lastname: Otani
authors.forename: Jun
authors.initials: J
authors.lastname: Kozaki
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Unoki
authors.forename: Masamitsu
authors.initials: M
authors.lastname: Takeuchi
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Minami
authors.forename: Kazunori
authors.initials: K
authors.lastname: Miyata
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001548:Benzalkonium Compounds / Q000008:administration & dosage* / Q000009:adverse effects; D003008:Cloprostenol / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D003229:Conjunctival Diseases / Q000139:chemically induced; D003315:Cornea / Q000187:drug effects; D003316:Corneal Diseases / Q000139:chemically induced; D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D000077338:Latanoprost; D008297:Male; D009798:Ocular Hypertension / Q000188:drug therapy / Q000503:physiopathology; D009883:Ophthalmic Solutions / Q000008:administration & dosage / Q000009:adverse effects; D011310:Preservatives, Pharmaceutical / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies; D011461:Prostaglandins F, Synthetic / Q000008:administration & dosage* / Q000009:adverse effects; D014065:Tonometry, Ocular; D000069557:Travoprost; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents; D001548:Benzalkonium Compounds; D009883:Ophthalmic Solutions; D011310:Preservatives, Pharmaceutical; D011461:Prostaglandins F, Synthetic; D003008:Cloprostenol; D000077338:Latanoprost; D000069557:Travoprost