Advancements in glaucoma care: The shift to preservative-free
A common preservative, benzalkonium (BAK), can be added to eye drops to prevent bacterial growth, extending the shelf-life of medications and making them more cost effective. BAK may also enhance corneal penetration, potentially facilitating increased penetration of active ingredients in preserved formulations. However, research shows that, when used regularly, drops containing BAK and other preservatives may lead to damage of the ocular surface, potentially causing irritation and worsening symptoms of dry eye and ocular surface disease.2
In the case of many patients, as their glaucoma advances, so does their need for multiple eyedrop medications. Side effects can be further exacerbated by the additive effect of preservatives across medications, leading to reduced quality of life and poor adherence.
With advancements in formulations and delivery options, we now have choices available that can lessen the preservative load for patients’ ocular surface and offer treatment opportunities for eyecare professionals.
IYUZEH, recently available in the USA, is the first preservative-free latanoprost for lowering the IOP of open-angle glaucoma and ocular hypertension. In clinical studies, IYUZEH demonstrated clinically meaningful intraocular pressure- (IOP) lowering effects when compared with Xalatan, and was well tolerated throughout the trial.3 In the two clinical trials conducted with IYUZEH the most frequently reported ocular adverse reactions were conjunctival hyperemia and eye irritation. IYUZEH provides patients with an option that offers the reduction of IOP with a lower incidence of ocular treatment-emergent adverse events.
When eye conditions, such as NK, are present in addition to glaucoma, we must ensure optimal management of both conditions and consider the full picture. For NK, limiting preservatives can help to promote healing.
Similarly, if there are signs of pre-existing ocular surface disease, it is crucial to consider minimizing preservative exposure to prevent further damage, alongside efforts to reduce IOP.
In addition, if a patient is concerned about medication side effects, opting for a preservative-free therapy may be most appropriate to minimize irritation and potential damage to the ocular surface that is caused by preservatives. This is key if they are also using multiple other treatments or drops already.
In this case, it was important to effectively manage the patient’s multiple conditions, including advanced ocular surface disease, while prioritizing effective reduction in IOP.
The patient’s personal concerns and priorities always factor into my recommended management plan to maximize adherence and ensure the best outcomes. For this patient, key considerations included IOP reduction, preventing further damage to the ocular surface, and ultimately improving quality of life.
Overall, IYUZEH resulted in a significant reduction of IOP from 17 to 13 in the worse eye, which has been stabilized for 7 months now. Due to the advanced ocular surface disease and inflammation that were present, I was initially reluctant to add a preserved prostaglandin analog to this patient’s treatment plan. IYUZEH was well tolerated without aggravating the eye unnecessarily, as well as effectively managing the advanced glaucoma.
For this patient, my priority was to reduce her high IOP to prevent disease progression and impairment of vision. The patient was also experiencing dry eye and felt this was further exacerbated by OTC drops.
As she was very reluctant to use drops, it was important to offer a solution that addressed these concerns and prevented further damage to the ocular surface.
After 6 weeks, IOP was reduced by 8 mmgH. IYUZEH was well tolerated, and the patient reported that she experienced no stinging or burning when using the drops. The patient noted she still “doesn’t like drops,” but promised good compliance. This is reinforced by studies that have shown patient glaucoma drop compliance declines in the presence of worsening dry eye disease symptoms.4
Why choose preservative-free IYUZEH?
IYUZEH has demonstrated consistent IOP-lowering effects and proven tolerability across multiple trials in the U.S. and Europe. In randomized, controlled clinical trials of patients with open-angle glaucoma or ocular hypertension with mean baseline IOP of 19-24 mmHg, IYUZEH lowered IOP by 3 – 8 mmHg versus 4 – 8 mmHg by Xalatan, which is preserved with BAK. In addition, a recent real-world study found that 97.3% of treatment-naive patients were satisfied or very satisfied with IYUZEH, particularly in terms of tolerability, absence of ocular symptoms, and ease-of-use.5
Less than 7% of patients reported symptoms of ocular surface disease, and in the cases in which this occurred, symptoms were reported to be mild.5
This demonstrable impact in both real-world studies and our clinical experiences highlights IYUZEH as an effective option to reduce preventable ocular surface disease caused by preservatives, empowering us to prioritize our patients’ comfort, in addition to effective treatment and management of glaucoma.
About IYUZEH
IYUZEH (latanoprost ophthalmic solution) 0.005%, an opalescent, white to slightly yellow ophthalmic solution, is a topical formulation of latanoprost that is indicated for the reduction of elevated intraocular pressure (IOP) in patients with open-angle glaucoma (OAG) or ocular hypertension (OHT). IYUZEH does not contain a preservative – it is the first and only preservative-free formulation of latanoprost, the most prescribed prostaglandin F2α analogue (PGA), in the United States. The recommended dosage of IYUZEH is one drop in the affected eye(s) once daily in the evening. If one dose is missed, treatment should continue with the next dose as normal. Reduction of the IOP starts approximately 3 to 4 hours after administration and the maximum effect is reached after 8 to 12 hours. IOP reduction is present for at least 24 hours.
In the two clinical trials conducted with IYUZEH (latanoprost ophthalmic solution) 0.005%, the most frequently reported ocular adverse reactions were conjunctival hyperemia (34%) and eye irritation (19%) compared to Xalatan, the preserved 0.005% latanoprost reference product which reported conjunctival hyperemia (37%) and eye irritation (31%).
Learn more about IYUZEH at iyuzeh.com.
