6 Preservatives such as benzalkonium chloride (BAK) are toxic to the ocular surface and may aggravate the signs and symptoms of ocular surface disease (OSD). 7 While non-selective β-blockers, such as timolol, can cause bradycardia, arrhythmias and reductions in blood pressure, PGAs lack systemic side effects 1 but may be associated with distinctive ocular adverse events (AEs), such as conjunctival hyperaemia. 6 Despite numerous comparative efficacy studies to date, few have compared different PF PGA therapies. There are only two available PGA–timolol preservative-free (PF) FDCs PF bimatoprost 0.03%–timolol 0.5% (bimatoprost–timolol) and PF tafluprost 0.0015%–timolol 0.5% (tafluprost–timolol). 1 The greatest reduction of IOP is obtained with PGAs (25%–35%) followed by non-selective β-blockers (20%–25%), such as timolol however, when patients fail to achieve IOP targets with monotherapy, fixed-dose combinations (FDCs) should be considered. 3 4 Several categories of IOP-lowering topical drugs are available including prostaglandin analogues (PGA) (generally the first-line treatment), β-adrenergic blockers, carbonic anhydrase inhibitors, α-adrenergic agonists and miotics. Medical treatment of ocular hypertension (OH) and open-angle glaucoma (OAG) focuses on the long-term control of IOP. 1 In 2013, approximately 64.3 million people were affected by glaucoma, and the number is expected to grow to 111.8 million by 2040. Glaucoma is a disorder often associated with elevated intraocular pressure (IOP) which, if left untreated, leads to retinal ganglion cell death, thinning of the retinal nerve fibre layer, optic nerve damage and cupping of the optic disc.

Carlo traverso genova