{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T15:59:52Z","timestamp":1790351992644,"version":"4.1.0"},"reference-count":47,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,7,27]],"date-time":"2020-07-27T00:00:00Z","timestamp":1595808000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Exper Ophthalmology"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Use of topical glaucoma medications has been reported to cause ocular surface (OS) discomfort and inflammation. This study explores the profile of inflammatory cytokines and OS symptoms induced in response to preserved and non\u2010preserved drops.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Prospective, randomized evaluation on 36 treatment\u2010na\u00efve patients over 24\u2009months of three differently preserved glaucoma drop preparations: Preservative\u2010free (PF), polyquad (PQ) and benzalkonium chloride (BAK). Study participants were evaluated at baseline and then at 1, 3, 6, 12 and 24\u2009months while on medication. At each visit, participants completed the OS disease index (OSDI) questionnaire, had basal tear sampling and impression cytology (IC) of the conjunctival epithelium. Quantitative polymerase chain reaction was performed to measure the gene expression of inflammatory cytokines [interleukin (IL)\u20106, IL\u20108, IL\u201010, IL\u201012A, IL\u201012B, IL\u201017A, IL\u20101\u03b2 and tumour necrosis factor\u2010\u03b1] in the IC samples. Corresponding protein expression of cytokines in tear samples was assessed by the Becton\u2010Dickinson cytometric bead arrays.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared to PF and PQ groups, mRNA and protein expression of IL\u20106, IL\u20108 and IL\u20101\u03b2 increased in samples from the BAK group in a time\u2010dependent fashion, whereas all other cytokines showed a non\u2010significant increase. In the BAK group, there was a strong correlation between OSDI and the levels of IC\/IL\u20101\u03b2 (<jats:italic>r<\/jats:italic> =\u2009.832, <jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup> =\u2009.692 and <jats:italic>P<\/jats:italic> =\u2009.040); IC\/IL\u201010 (<jats:italic>r<\/jats:italic> =\u2009.925, <jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup> =\u2009.856 and <jats:italic>P<\/jats:italic> = .008) and tear\/IL\u20101\u03b2 (<jats:italic>r<\/jats:italic> =\u2009.899, <jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup> =\u2009.808 and <jats:italic>P<\/jats:italic> =\u2009.014).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>BAK\u2010preserved topical drops stimulate a sterile inflammatory response on the OS within 3 months which is maintained thereafter, whereas PF\u2010drops and PQ\u2010preserved drops showed no significant OS inflammation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ceo.13814","type":"journal-article","created":{"date-parts":[[2020,6,21]],"date-time":"2020-06-21T10:24:53Z","timestamp":1592735093000},"page":"973-982","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Profiling ocular surface responses to preserved and non\u2010preserved topical glaucoma medications: A 2\u2010year randomized evaluation study"],"prefix":"10.1111","volume":"48","author":[{"given":"Imran","family":"Mohammed","sequence":"first","affiliation":[{"name":"Academic Ophthalmology, Division of Clinical Neuroscience University of Nottingham  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bina","family":"Kulkarni","sequence":"additional","affiliation":[{"name":"Academic Ophthalmology, Division of Clinical Neuroscience University of Nottingham  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lana 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