New Opportunities in Non-Preservative Glaucoma Therapy
Most of the medicines used for the treatment of glaucoma include a preservative in various concentrations. With long-term topical therapy, patients with glaucoma may develop dry eye syndrome (DES). The severity of symptoms depends on the number of drugs used and the presence of a preservative in the...
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Ophthalmology Publishing Group
2021-07-01
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| Series: | Oftalʹmologiâ |
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| Online Access: | https://www.ophthalmojournal.com/opht/article/view/1542 |
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| author | A. A. Antonov I. V. Kozlova A. A. Vitkov |
| author_facet | A. A. Antonov I. V. Kozlova A. A. Vitkov |
| author_sort | A. A. Antonov |
| collection | DOAJ |
| description | Most of the medicines used for the treatment of glaucoma include a preservative in various concentrations. With long-term topical therapy, patients with glaucoma may develop dry eye syndrome (DES). The severity of symptoms depends on the number of drugs used and the presence of a preservative in them. Against the background of DES progression, compliance to glaucoma therapy may decrease, and, consequently, the effectiveness of the treatment may decrease. Currently, new non-preservative hypotensive drugs containing brimonidine, as well as a fixed combination (FC) of dorzolamide and timolol, are available on the market.Purpose: to compare assessment of the hypotensive effect and tolerability of preservative-free drugs FC Dorzolamid 20 mg/ml, Timolol 5 mg/ml (Dortmol Antiglau ECO) and Brimonidine 2 mg/ml (Brim Antiglau ECO) when switching from similar drugs containing a preservative in patients with compensated glaucoma.Patients and methods. In this prospective clinical study, 60 patients (60 eyes) with compensated primary open-angle glaucoma on combined topical therapy were examined. In group 1 (30 patients, 30 eyes), the combinations of dorzolamide / timolol or brinzolamide / timolol were switched with the non-preservative Dortmol Antiglau ECO. In group 2 (30 patients, 30 eyes), the brimonidine as part of the medication regimen were replaced with the non-preservative Brim Antiglau ECO. The level of corneal-compensated IOP was assessed before the switch in therapy and after 1 month. Subjective feelings and objective signs of the treatment’s use were monitored during examination and using a questionnaire, which was compiled to study the tolerance of therapy.Results. Switching to a preservative-free combination of dorzolamide and timolol resulted in a reduction in complaints of irritation, lacrimation, and foreign body sensation. The efficiency control did not reveal a significant change (p > 0.05) in the cornealcompensated intraocular pressure (IOPcc). When transferred to the Brim Antiglau ECO as part of the local hypotensive treatment, intraocular pressure decreased significantly (p < 0.05). The average total score characterizing drug intolerance, when evaluated by the patient, decreased by 2.4 times, by the attending physician-by 1.9 times. The degree of conjunctival hyperemia on the MacMonnies photographic scale decreased in both groups.Conclusion. Preservative-free drugs can be recommended for most patients with glaucoma as a starting treatment and as a replacement for current therapy. |
| format | Article |
| id | doaj-art-733cd38993e94ee28a2b689d30b3ac22 |
| institution | Kabale University |
| issn | 1816-5095 2500-0845 |
| language | Russian |
| publishDate | 2021-07-01 |
| publisher | Ophthalmology Publishing Group |
| record_format | Article |
| series | Oftalʹmologiâ |
| spelling | doaj-art-733cd38993e94ee28a2b689d30b3ac222025-08-20T04:00:20ZrusOphthalmology Publishing GroupOftalʹmologiâ1816-50952500-08452021-07-0118226026510.18008/1816-5095-2021-2-260-265755New Opportunities in Non-Preservative Glaucoma TherapyA. A. Antonov0I. V. Kozlova1A. A. Vitkov2Research Institute of Eye DiseasesResearch Institute of Eye DiseasesResearch Institute of Eye DiseasesMost of the medicines used for the treatment of glaucoma include a preservative in various concentrations. With long-term topical therapy, patients with glaucoma may develop dry eye syndrome (DES). The severity of symptoms depends on the number of drugs used and the presence of a preservative in them. Against the background of DES progression, compliance to glaucoma therapy may decrease, and, consequently, the effectiveness of the treatment may decrease. Currently, new non-preservative hypotensive drugs containing brimonidine, as well as a fixed combination (FC) of dorzolamide and timolol, are available on the market.Purpose: to compare assessment of the hypotensive effect and tolerability of preservative-free drugs FC Dorzolamid 20 mg/ml, Timolol 5 mg/ml (Dortmol Antiglau ECO) and Brimonidine 2 mg/ml (Brim Antiglau ECO) when switching from similar drugs containing a preservative in patients with compensated glaucoma.Patients and methods. In this prospective clinical study, 60 patients (60 eyes) with compensated primary open-angle glaucoma on combined topical therapy were examined. In group 1 (30 patients, 30 eyes), the combinations of dorzolamide / timolol or brinzolamide / timolol were switched with the non-preservative Dortmol Antiglau ECO. In group 2 (30 patients, 30 eyes), the brimonidine as part of the medication regimen were replaced with the non-preservative Brim Antiglau ECO. The level of corneal-compensated IOP was assessed before the switch in therapy and after 1 month. Subjective feelings and objective signs of the treatment’s use were monitored during examination and using a questionnaire, which was compiled to study the tolerance of therapy.Results. Switching to a preservative-free combination of dorzolamide and timolol resulted in a reduction in complaints of irritation, lacrimation, and foreign body sensation. The efficiency control did not reveal a significant change (p > 0.05) in the cornealcompensated intraocular pressure (IOPcc). When transferred to the Brim Antiglau ECO as part of the local hypotensive treatment, intraocular pressure decreased significantly (p < 0.05). The average total score characterizing drug intolerance, when evaluated by the patient, decreased by 2.4 times, by the attending physician-by 1.9 times. The degree of conjunctival hyperemia on the MacMonnies photographic scale decreased in both groups.Conclusion. Preservative-free drugs can be recommended for most patients with glaucoma as a starting treatment and as a replacement for current therapy.https://www.ophthalmojournal.com/opht/article/view/1542glaucomahypotensive therapynon-preservative therapyocular surfacedorzolamidetimololbrimonidine |
| spellingShingle | A. A. Antonov I. V. Kozlova A. A. Vitkov New Opportunities in Non-Preservative Glaucoma Therapy Oftalʹmologiâ glaucoma hypotensive therapy non-preservative therapy ocular surface dorzolamide timolol brimonidine |
| title | New Opportunities in Non-Preservative Glaucoma Therapy |
| title_full | New Opportunities in Non-Preservative Glaucoma Therapy |
| title_fullStr | New Opportunities in Non-Preservative Glaucoma Therapy |
| title_full_unstemmed | New Opportunities in Non-Preservative Glaucoma Therapy |
| title_short | New Opportunities in Non-Preservative Glaucoma Therapy |
| title_sort | new opportunities in non preservative glaucoma therapy |
| topic | glaucoma hypotensive therapy non-preservative therapy ocular surface dorzolamide timolol brimonidine |
| url | https://www.ophthalmojournal.com/opht/article/view/1542 |
| work_keys_str_mv | AT aaantonov newopportunitiesinnonpreservativeglaucomatherapy AT ivkozlova newopportunitiesinnonpreservativeglaucomatherapy AT aavitkov newopportunitiesinnonpreservativeglaucomatherapy |