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Prevalence of ocular symptoms and signs with preserved and preservative free glaucoma medication
  1. P J Pisella1,2,
  2. P Pouliquen3,
  3. C Baudouin1,4
  1. 1APHP Ambroise Paré Hospital, University Paris V, Ophthalmology Department, 9, avenue Charles de Gaulle, 92100 Boulogne, France
  2. 2Bretonneau University Hospital, Ophthalmology Department, 2, boulevard Tonnellé, 37044 Tours Cedex 1, France
  3. 3Théa Laboratories, 12, rue Louis-Blériot, - ZI du Brézet, 63017 Clermont-Ferrand, Cedex 2, France
  4. 4XV-XX National Hospital, University Paris V, 28, rue de Charenton, 75012 Paris, France
  1. Correspondence to: C Baudouin; APHP Ambroise Paré Hospital, University Paris V, Ophthalmology Department, 9, avenue Charles de Gaulle, 92100 Boulogne, France; baudouin{at}


Aim: To determine the incidence of ocular toxicity of preservatives with glaucoma medications.

Methods: A prospective epidemiological survey was carried out in 1999 by 249 ophthalmologists on 4107 patients. Ocular symptoms, conjunctiva, cornea, and eyelids were assessed. A χ2 test was used for differences between preserved eye drops (P) and preservative free eye drops (PF).

Results: 84% patients used P, 13% received PF, and 3% a combination of P and PF eye drops. All symptoms were more prevalent with P than with PF drops (p<0.001): discomfort upon instillation (43% versus 17%), and symptoms between instillations such as burning-stinging (40% versus 22%), foreign body sensation (31% versus 14%), dry eye sensation (23% versus 14%), tearing (21% versus 14%), and eyelid itching (18% versus 10%). An increased incidence (>2 times) of ocular signs was seen with P eye drops. The prevalence of signs and symptoms was dose dependent, increasing with the number of P drops. A reduction in the symptoms and signs was observed when patients changed from P to PF eye drops (p<0.001).

Conclusions: Symptoms and signs are less prevalent when PF drops are used. Moreover, most of the adverse reactions induced by P glaucoma medication are reversible after removing preservatives.

  • preservatives
  • glaucoma
  • ocular surface damage

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