title: [Preservative-free glaucoma treatment : Selection of the correct treatment in 1 min].
abstract: BACKGROUND
  The presence of preservatives in topical glaucoma treatments may impact ocular surface function and structure. For treatment to be effective, side effects need to be minimized, in order to promote compliance and allow continuation of therapy. Therefore, in daily clinical practice, it needs to be decided on an individual basis whether a preservative-free treatment is required.
  
  
  OBJECTIVE
  This study aimed to develop a questionnaire which helps to quickly and easily identify patients who require preservative-free treatment.
  
  
  METHODS
  A questionnaire was prepared to collect relevant clinical findings needed to make a therapeutic decision (preservative-free required? Yes/No). Moreover, a rating scheme was developed to enable efficient final assessment of the collected data. To check their practicability in daily clinical practice, both instruments were tested in 11 ophthalmological centers in Germany.
  
  
  RESULTS
  The questionnaire and rating scheme were easy to use, integrated efficiently into everyday routine, and performed in about 1 min. Data of 1150 glaucoma patients were collected and preservative-free eyedrops recommended for 586 (51 %). Parameters most frequently associated with such a recommendation were a reduced tear film break-up time of < 10 s (87.5 %) or marked corneal staining (65.5 %).
  
  
  CONCLUSIONS
  The presented approach helps to decide within 1 min, in daily clinical practice, whether preservative-free glaucoma threatment should be recommended. Individualized therapy decisions can thus be made, allowing goal-oriented use of preservative-free antiglaucomatosa. This might help to promote compliance and lead to reduced progression of glaucoma.
authors.affiliation: Augenarztpraxis Dr. Pfennigsdorf, Marktplatz 13, 56751, Polch, Deutschland. dr_pfennigsdorf@icloud.com.
authors.forename: S
authors.initials: S
authors.lastname: Pfennigsdorf
authors.affiliation: nordBLICK® Praxis Elmschenhagen, Kiel, Deutschland.
authors.forename: P
authors.initials: P
authors.lastname: Eschstruth
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001548:Benzalkonium Compounds / Q000008:administration & dosage / Q000737:chemistry; D000066491:Clinical Decision-Making / Q000379:methods*; D005260:Female; D005858:Germany / Q000453:epidemiology; D005901:Glaucoma / Q000188:drug therapy* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000008:administration & dosage* / Q000737:chemistry; D057240:Patient Preference; D018579:Patient Selection; D011310:Preservatives, Pharmaceutical / Q000008:administration & dosage* / Q000737:chemistry; D015995:Prevalence; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires
chemical_list: D001548:Benzalkonium Compounds; D009883:Ophthalmic Solutions; D011310:Preservatives, Pharmaceutical
keywords: Compliance; Drug therapy; Glaucoma; Ocular surface disease; Pharmaceutical preservatives