Efficacy and patient tolerability of preservative‐free latanoprost compared with preservative prostaglandin analogs in patients with ocular hypertension or glaucoma

Purpose The purpose of this study was to compare the local tolerability of the preservative‐free (PF) latanoprost with other preservative prostaglandin analogs (PGA) for the treatment of open‐angle glaucoma and ocular hypertension. Methods In this prospective study, until now 125 eyes of 63 patients treated with a PGA monotherapy were included and for 16 of them treatment was switched for PF latanoprost. Ocular subjectve symptoms were evaluated. Non invasive tear break‐up time (NIK BUT), tear meniscus height (TMH), conjunctival hyperemia in Keratograph 5M® and intraocular pressure (IOP) were measured at baseline and 6 months after commencing treatment with PF latanoprost. Results Mean conjonctival hyperemia was slightly higher with preservative latanoprost (1.19) and significantly higher with the preservative travoprost (1.34; p = 0.013) and bimatoprost (1.33; p = 0.05) than PF latanoprost (1.06). The two most frequent subjective symptoms (burning upon instillation and conjunctival hyperemia between instillations) were less reported with PF latanoprost than with other preservative PGA. After 6 months of treatment with PF latanoprost, in patients with prior travoprost monotherapy, mean conjonctival hyperemia (1.31 vs. 1.13; p = 0.04) and TMH (0.29 vs. 0.32; p = 0.04) improved significantly. In patients with prior preservative latanoprost monotherapy, TMH improved (0.31 vs. 0.35 p = 0.03). There was no statistical significant difference on IOP at 6 months between PF latanoprost and preservative latanoprost (16.3 ± 3.5 vs. 15.8 ± 3.1 mmHg; p = 0.07) and travoprost (15.8 ± 2.5 vs. 15.5 ± 1.5; p = 0.6). Conclusions These preliminary results show that PF latanoprost has better subjective and objective local tolerance than preservative PGA. Switching to PF latanoprost seems to maintain IOP at the same level as preservative PGA but improve ocular surface toxicity.