title: First experience with BAK-free travoprost 0.004% in topical glaucoma medication.
abstract: OBJECTIVE
  Benzalkonium chloride (BAK)-free travoprost 0.004% (Travatan Z(®), Alcon Laboratories, Inc, Fort Worth, TX) is a new formulation that was developed with the aim of creating a formulation of travoprost that would maintain the intraocular pressure (IOP)-lowering efficacy and have an improved overall safety profile, particularly improved ocular surface tolerability.
  
  
  METHODS
  Thirty newly diagnosed primary open-angle glaucoma (POAG) patients were treated with BAK-free travoprost 0.004%. IOP readings were recorded at baseline before initiating treatment, at 4-6 weeks, and after 12 weeks of starting treatment. In addition, patient demographics, subjective symptoms (ie, burning, foreign-body sensation, itching, and stinging), and objective clinical signs such as conjunctival hyperemia were collected. Subjective symptoms were evaluated using a four-point scale ranging from "no symptoms," "mild symptoms," "moderate symptoms" to "severe symptoms." As for clinical signs, severity of conjunctival hyperemia was evaluated. All other adverse events were collected.
  
  
  RESULTS
  BAK-free travoprost 0.004% provided an IOP decrease in all patients, with an overall mean of 28.3 ± 2.1 mmHg at baseline to a mean of 18.7 ± 1.6 mmHg at 4-6 weeks, and a mean of 18.4 ± 1.4 mmHg after 12 weeks. Both subjective symptoms and objective clinical signs were very few after treatment.
  
  
  CONCLUSIONS
  The results demonstrate that BAK-free travoprost 0.004% is an effective, well tolerated, and safe medication in POAG patients.
authors.affiliation: Department of Ophthalmology, Cairo University, Cairo, Egypt.
authors.forename: Ahmed Salah
authors.initials: AS
authors.lastname: Gado
authors.forename: Tamer Ahmed
authors.initials: TA
authors.lastname: Macky