Sapienza University of Rome, Centre of Ocular Electrophysiology, Department of Sense Organs, viale del policlinico 155, 00161 Rome, Italy.
Expert Opin Pharmacother. 2012 Sep;13(13):1829-35. doi: 10.1517/14656566.2012.705830. Epub 2012 Jul 7.
The purpose of this study was to verify the ocular comfort of a fixed topical combination of brinzolamide 1% plus timolol 0.5% suspension vs. dorzolamide 2% plus timolol 0.5% solution, both preserved with benzalkonium chloride (BAK), in patients with primary open-angle glaucoma (POAG) through subjective and objective methods. BAK is the most commonly used preservative in topical glaucoma medications.
62 subjects were examined and included in the analysis. Each patient was asked to complete a questionnaire on symptoms (Ocular Surface Disease Index) and then underwent a series of examinations. The Ocular Protection Index evaluated the risk of damage to the ocular surface, and was expressed as the ratio between fluorescein breakup time and blinking interval. These and other analyses were repeated 30 days after instillation of the new eye drop treatment.
The results demonstrated that patients enrolled with the preserved fixed combination of dorzolamide or brinzolamide represented a subgroup of patients in which the discomfort symptoms were supposedly justified by the presence of BAK used chronically in antihypertensive drops. Ocular discomfort scores were significantly higher with dorzolamide/timolol than brinzolamide/timolol (p < 0.0001).
This work shows the better tolerability of brinzolamide 1% plus timolol 0.5% suspension, compared with dorzolamide 2% plus timolol 0.5% solution. Fortunately, some of the adverse reactions induced by preserved eye drop glaucoma medication are reversible after removing the preservatives. Both the potential for added benefit and patient compliance should be considered when selecting ocular hypotensive therapy.
本研究旨在通过主观和客观方法验证贝他根（BAK）保存的布林佐胺 1%加噻吗心安 0.5%混悬液与多佐胺 2%加噻吗心安 0.5%溶液固定局部联合制剂在原发性开角型青光眼（POAG）患者中的眼部舒适度。BAK 是局部青光眼药物中最常用的防腐剂。
共检查了 62 例患者，并进行了分析。每位患者均填写了一份症状问卷（眼表面疾病指数），然后进行了一系列检查。眼保护指数评估了眼表面损伤的风险，并用荧光素破裂时间与眨眼间隔的比值表示。这些和其他分析在新滴眼剂治疗 30 天后重复进行。
结果表明，接受多佐胺或布林佐胺保存固定联合治疗的患者代表了一组亚组患者，他们的不适症状是由长期使用降压滴眼剂中的 BAK 引起的。多佐胺/噻吗心安的眼部不适评分明显高于布林佐胺/噻吗心安（p<0.0001）。
与多佐胺 2%加噻吗心安 0.5%溶液相比，本研究显示布林佐胺 1%加噻吗心安 0.5%混悬液具有更好的耐受性。幸运的是，一些由防腐剂滴眼剂引起的不良反应在去除防腐剂后是可逆的。在选择眼降压治疗时，应考虑附加益处的潜力和患者的顺应性。
