{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T01:44:42Z","timestamp":1791942282329,"version":"4.3.4"},"reference-count":22,"publisher":"Korean Ophthalmological Society","issue":"5","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Samil Pharmaceutical","id":[{"id":"https:\/\/ror.org\/05ke98p93","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["ekjo.org"],"crossmark-restriction":true},"short-container-title":["Korean J Ophthalmol"],"published-print":{"date-parts":[[2026,10,5]]},"abstract":"<jats:p>Purpose: To compare the effects of preservative-free (PF) and benzalkonium chloride (BAK)-preserved latanoprost on intraocular pressure (IOP), objective ocular surface signs, and subjective symptoms in patients with primary open-angle glaucoma (POAG).Methods: A prospective, randomized, cross-over study was conducted with 29 POAG patients. Participants were randomized to receive either PF or BAK-preserved latanoprost for 2 months, followed by a cross-over to the alternative formulation for another 2 months. IOP, tear break-up time (TBUT), conjunctival staining, and patient-reported symptoms were assessed at baseline and after each treatment period.Results: IOP was significantly and comparably reduced by both formulations (PF: 16.49 \u00b1 3.89 to 15.05 \u00b1 2.55 mmHg, &lt;i&gt;p&lt;\/i&gt; = 0.007; preserved: 15.60 \u00b1 3.79 to 13.79 \u00b1 3.53 mmHg, &lt;i&gt;p&lt;\/i&gt; &lt; 0.001). However, BAK-preserved latanoprost significantly shortened TBUT (7.23 \u00b1 2.37 to 6.07 \u00b1 2.40 seconds, &lt;i&gt;p&lt;\/i&gt; = 0.007) and worsened conjunctival staining (0.31 \u00b1 0.60 to 0.69 \u00b1 0.71, &lt;i&gt;p&lt;\/i&gt; = 0.013), whereas PF latanoprost maintained tear film stability (TBUT, 5.61 \u00b1 2.19 to 5.22 \u00b1 2.26 seconds; &lt;i&gt;p&lt;\/i&gt; = 0.337) and improved conjunctival staining (0.76 \u00b1 0.83 to 0.31 \u00b1 0.60, &lt;i&gt;p&lt;\/i&gt; = 0.003). Subjective symptoms including burning (0.34 \u00b1 0.81 [PF] vs. 1.21 \u00b1 1.17 [preserved], &lt;i&gt;p&lt;\/i&gt; = 0.001), stinging (0.14 \u00b1 0.35 vs. 0.79 \u00b1 0.79, &lt;i&gt;p&lt;\/i&gt; &lt; 0.001), and pruritus (0.21 \u00b1 0.41 vs. 0.50 \u00b1 0.64, &lt;i&gt;p&lt;\/i&gt; = 0.030) were markedly lower with the PF formulation. After cross-over, patients switching from preserved to PF latanoprost showed improvements in burning (&lt;i&gt;p&lt;\/i&gt; = 0.012) and photophobia (&lt;i&gt;p&lt;\/i&gt; &lt; 0.001).Conclusions: PF latanoprost provides equivalent IOP-lowering efficacy to BAK-preserved latanoprost while offering significant advantages in ocular surface health and symptom tolerability. These findings support PF formulations as a preferred first-line option for glaucoma management to enhance treatment tolerability and patients\u2019 quality of life.<\/jats:p>","DOI":"10.3341\/kjo.2026.0002","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T23:29:38Z","timestamp":1779751778000},"page":"536-545","update-policy":"https:\/\/doi.org\/10.3341\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of Preservative-Free and Preserved Latanoprost in Primary Open-Angle Glaucoma: A Randomized Cross-Over Study"],"prefix":"10.3341","volume":"40","author":[{"given":"Ji Heon","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea"},{"name":"Department of Ophthalmology, National Health Insurance Service Ilsan Hospital, Goyang, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwanghyun","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, National Health Insurance Service Ilsan Hospital, Goyang, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jong Woon","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, National Health Insurance Service Ilsan Hospital, Goyang, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1893","reference":[{"key":"ref1","first-page":"1967","volume-title":"Latanoprost in the treatment of glaucoma","author":"Alm","year":"2014"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2025-egsguidelines"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1038\/s41433-021-01668-x"},{"key":"ref4","first-page":"3","volume-title":"The use of benzalkonium chloride in topical glaucoma treatment: an investigation of the efficacy and safety of benzalkonium chloride-preserved intraocular pressure-lowering eye drops and their effect on conjunctival goblet cells","author":"Nagstrup","year":"2023"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-94574-x"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2012-302121"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-021-01731-9"},{"key":"ref8","first-page":"1599","volume-title":"A phase III study comparing preservative-free latanoprost eye drop emulsion with preserved latanoprost in open-angle glaucoma or ocular hypertension","author":"Baudouin","year":"2025"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.3341\/kjo.2021.0010"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2013.09.013"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1038\/s41433-025-03819-w"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.2147\/opth.s414015"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1097\/opx.0b013e318196bf49"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1046\/j.1475-1313.1998.00385.x"},{"key":"ref15","first-page":"1319628","volume-title":"Comparison of efficacy and ocular surface disease index score between bimatoprost, latanoprost, travoprost, and tafluprost in glaucoma patients","author":"El Hajj Moussa","year":"2018"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.2147\/opth.s176605"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2004.12.035"},{"key":"ref18","first-page":"414","volume-title":"Prevalence and correlates of self-reported nonadherence with eye drop treatment: the Belgian Compliance Study in Ophthalmology (BCSO)","author":"Vandenbroeck","year":"2011"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2015.03.026"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1097\/ijg.0000000000001983"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10112408"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1155\/2010\/939602"}],"container-title":["Korean Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.ekjo.org\/upload\/pdf\/kjo-2026-0002.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/www.ekjo.org\/journal\/view.php?doi=10.3341\/kjo.2026.0002","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/www.ekjo.org\/upload\/pdf\/kjo-2026-0002.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:51:58Z","timestamp":1791939118000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.ekjo.org\/journal\/view.php?doi=10.3341\/kjo.2026.0002"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,5]]},"references-count":22,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,10]]}},"URL":"https:\/\/doi.org\/10.3341\/kjo.2026.0002","relation":{},"ISSN":["1011-8942","2092-9382"],"issn-type":[{"value":"1011-8942","type":"print"},{"value":"2092-9382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,5]]},"assertion":[{"value":"2026-01-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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