Abstract
Purpose :
Lack of efficacy and local intolerance are now known to be the two main reasons for glaucoma treatment change. It has been demonstrated that preservatives alter local tolerability. With the newly available preservative-free (PF) prostaglandin (PG) Monoprost®, it is important to confirm the long-term efficacy and improvement of ocular signs and symptoms after switching from preserved to PF glaucoma treatment. This was the objective of the FREE survey (Follow-up of glaucoma patients tReated with prostaglandins EyEdrops).
Methods :
FREE is a prospective, European, multicentre survey implemented in ophthalmological private practices in France, the Netherlands, Norway, Poland and Sweden. Three study visits (inclusion and two visits after 6 and 12 months) were planned during the normal follow-up of the patients. Hyperaemia and patient satisfaction with regard to tolerance were the main evaluation criteria. Secondary parameters were: mean intraocular pressure (IOP); patient global opinion about the current glaucoma treatment; the ocular surface disease (OSD); the use of tear substitutes; the ocular signs; fluorescein corneal and conjunctival stainings; and tear BUT.
Results :
The final results from the five countries are presented here for the first time. From the analysis of 722 patients (463 in France, 98 in Poland, 94 in Sweden, 43 in the Netherlands and 24 in Norway), IOP is still stable after 6 months (Mean=16.7±1.64 mm Hg) and after 12 months (Mean=16.6±1.83 mm Hg) of treatment with PF latanoprost (Monoprost®). There is no significant difference with preserved treatments. At visit1, 88.6% of patients treated with PF latanoprost were satisfied regarding tolerance whereas only 65.3% of patients treated with a preserved treatment. Hyperaemia appeared to be less prevalent with preservative-free latanoprost than with preserved treatment (Visit1: 32.8% vs 58.6%) and at the subsequent visits (Visit2: 22.5% vs 47.7%). At visit2, the use of artificial tears had decreased for 49.5% of patients after switching to PF latanoprost.
Conclusions :
These results with long term use of PF latanoprost (Monoprost®) in a large cohort confirm the efficacy and stability of the IOP after 12 months of treatment. Furthermore, they confirm the clinical benefit of switching from a preserved to a PF PG for better treatment tolerability, patient satisfaction and quality of life whilst retaining efficacy.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.