ReviewThe British journal of ophthalmology2018
Preservatives in glaucoma medication.
Review in The British journal of ophthalmology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
50 citing papers in PubMed, 3 syntheses or guidelines pooled it, 122 citations in OpenAlex.
- Association between the use of prostaglandin analogues and ocular surface disease: a systematic review.Eye (London, England) · 2025Pooled it
- Efficacy of Perfluorohexyloctane for the Treatment of Patients with Dry Eye Disease: A Meta-Analysis.Ophthalmic research · 2025Pooled it
- Efficacy of intracameral preservative-free triamcinolone acetonide in pediatric cataract surgery: a meta-analysis.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2020Pooled it
- Comparing the tolerability of preservative-free tafluprost versus preserved latanoprost in the management of glaucoma and ocular hypertension - an observer blinded active-control trial.Irish journal of medical science · 2024Trial
- Changing from preserved, to preservative-free cyclosporine 0.1% enhanced triple glaucoma therapy: impact on ocular surface disease-a randomized controlled trial.Eye (London, England) · 2023Trial
- A multicenter prospective comparative study evaluating cataract surgery and endoscopic cyclophotocoagulation either with or without iStent inject implantation in Brazilian patients with glaucoma.International ophthalmology · 2023Trial
- Tolerability in Glaucoma Patients Switched from Preserved to Preservative-Free Prostaglandin-Timolol Combination: A Prospective Real-Life Study.Clinical ophthalmology (Auckland, N.Z.) · 2022Trial
- Comparison of BAK-preserved latanoprost and polyquad-preserved travoprost on ocular surface parameters in patients with glaucoma and ocular hypertension.International ophthalmology · 2021Trial
- Clinical and Histopathological Evaluation of Maximal and Supramaximal Energy Direct Selective Laser Trabeculoplasty (DSLT): A Rabbit Model Safety Study.Lasers in surgery and medicine · 2026Article
- Original vs Shoji Edition of Tanito Microhook Trabeculotomy Combined with Cataract Surgery: Comparative Clinical Outcomes.Journal of glaucoma · 2026Article
- Comparative Effectiveness of Timolol-Based Fixed-Combination Regimens for Glaucoma: a Retrospective Cohort Study Using Target Trial Emulation Framework.Ophthalmology and therapy · 2026Article
- Could a Preservative Have Prevented the Extremely-Drug ResistantCurrent eye research · 2026Article
- Clinical features and management of medication-induced persistent corneal epithelial defects due to topical ophthalmic medications.Frontiers in medicine · 2026Article
- Optimizing Ocular Surface Disease (OSD) Management in Patients with Glaucoma: Expert Strategies from Asia.Clinical ophthalmology (Auckland, N.Z.) · 2026Article
- Impact of Preservative-Free Travoprost on Intraocular Pressure and Ocular Surface in Primary Open-Angle Glaucoma Patients.Life (Basel, Switzerland) · 2025Article
- Ocular Surface Parameters in Glaucoma Patients Treated with Topical Prostaglandin Analogs and the Importance of Switching to Preservative-Free Eye Drops-A Systematic Review.Life (Basel, Switzerland) · 2025Review
- Clinical Benefits of Preservative-Free Treatment for Glaucoma with a Focus on Preservative-Free Latanoprost.Ophthalmology and therapy · 2025Review
- Hyaluronate Protects From Benzalkonium Chloride-Induced Ocular Surface Toxicity.Translational vision science & technology · 2024Article
- Real-Life Study on the Efficacy and Tolerance of a Preservative-Free Surfactant-Free Latanoprost Eye Drop in Patients with Glaucoma.Ophthalmology and therapy · 2024Article
- Glaucoma: Current and New Therapeutic Approaches.Biomedicines · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Preservatives continue to be in widespread use in ophthalmic medications due to the convenience they provide, regulatory requirements and the higher cost of alternatives. Benzalkonium chloride (BAK) remains the most commonly used preservative but there is a trend towards the use of preservative-free (PF) drops for glaucoma, although at a higher price. An extensive body of literature explores BAK toxicity on ocular structures in animal and laboratory studies (in vitro and in vivo). Non-randomised controlled studies have provided some supporting evidence of its toxicity in patients, especially in those with pre-existing ocular surface disease (OSD) or on multiple medications. However, there have been very few randomised controlled trials that compare the same medication with and without BAK preservative. Several of these trials have never been published in any peer reviewed journals. Notwithstanding, those that have been published, have not demonstrated any clear benefits of the BAK-free formulations. Short duration and exclusion of those with OSD are limitations of these studies. There is a lack of evidence of clinically significant harm from a small number of BAK preserved drops in patients without OSD. This means that generally more expensive PF glaucoma medications should only be recommended for those on poly pharmacy or those with OSD but are not necessarily required for all patients.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.