{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T09:39:34Z","timestamp":1765186774854,"version":"3.46.0"},"reference-count":43,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T00:00:00Z","timestamp":1764979200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Cooper S.A., Greece"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background: The present study assesses the effectiveness and tolerability of preservative-free travoprost in patients with primary open-angle glaucoma (POAG), focusing on intraocular pressure (IOP) reduction and ocular surface health over a six-month period. Methods: The study was prospectively designed and conducted at the University General Hospital of Alexandroupolis, Greece. A total of 45 patients diagnosed with either POAG or ocular hypertension (OHT) were included in the study; all were either newly diagnosed or had previously discontinued prostaglandin therapy due to intolerance. Of these, 39 participants completed the study. All subjects were administered preservative-free travoprost once daily. Clinical evaluations were conducted at baseline (T0), and at 1 month (T1), 3 months (T3), 6 months (T6) and 12 months (T12) following treatment initiation. The primary outcomes encompassed reductions in intraocular pressure (IOP), Schirmer test values, tear break-up time (TBUT), conjunctival hyperemia, as well as measurements of retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thickness. Visual field parameters were also assessed. Results: A significant reduction in IOP was observed at T1, T3, T6 and T12 compared to baseline (p &lt; 0.01). Schirmer test scores improved significantly from T0 to all subsequent time points (p &lt; 0.01). Conjunctival hyperemia decreased significantly across follow-ups, while TBUT showed no significant change (p &gt; 0.05). No significant changes were noted in mean deviation (MD), pattern standard deviation (PSD), RNFL, or GCC thickness over six months. Conclusion: Preservative-free travoprost effectively reduces IOP while improving ocular surface health, particularly in tear production and conjunctival hyperemia.<\/jats:p>","DOI":"10.3390\/life15121870","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T09:17:36Z","timestamp":1765185456000},"page":"1870","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Preservative-Free Travoprost on Intraocular Pressure and Ocular Surface in Primary Open-Angle Glaucoma Patients"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5877-3642","authenticated-orcid":false,"given":"Minas","family":"Bakirtzis","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, University Hospital of Alexandroupolis, Democritus University of Thrace, Dragana Campus, 68100 Alexandroupolis, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5628-3765","authenticated-orcid":false,"given":"Panagiota","family":"Ntonti","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Hospital of Alexandroupolis, Democritus University of Thrace, Dragana Campus, 68100 Alexandroupolis, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0826-3959","authenticated-orcid":false,"given":"Eirini-Kanella","family":"Panagiotopoulou","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Hospital of Alexandroupolis, Democritus University of Thrace, Dragana Campus, 68100 Alexandroupolis, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5419-956X","authenticated-orcid":false,"given":"Aristeidis","family":"Konstantinidis","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Hospital of Alexandroupolis, Democritus University of Thrace, Dragana Campus, 68100 Alexandroupolis, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0849-5469","authenticated-orcid":false,"given":"Vangelis G.","family":"Manolopoulos","sequence":"additional","affiliation":[{"name":"Laboratory of Pharmacology, Faculty of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece"},{"name":"Individualised Medicine & Pharmacological Research Solutions Center (IMPReS), Democritus University of Thrace, 68100 Alexandroupolis, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2066-4782","authenticated-orcid":false,"given":"George","family":"Kolios","sequence":"additional","affiliation":[{"name":"Laboratory of Pharmacology, Faculty of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece"},{"name":"Individualised Medicine & Pharmacological Research Solutions Center (IMPReS), Democritus University of Thrace, 68100 Alexandroupolis, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4364-1943","authenticated-orcid":false,"given":"Georgios","family":"Labiris","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Hospital of Alexandroupolis, Democritus University of Thrace, Dragana Campus, 68100 Alexandroupolis, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"European Glaucoma Society (2021). Terminology and Guidelines for Glaucoma, 5th ed. Br. J. Ophthalmol., 105, 1\u2013169.","DOI":"10.1136\/bjophthalmol-2021-egsguidelines"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1136\/bjo.2005.081224","article-title":"The number of people with glaucoma worldwide in 2010 and 2020","volume":"90","author":"Quigley","year":"2006","journal-title":"Br. J. Ophthalmol."},{"key":"ref_3","first-page":"493","article-title":"Glaucoma","volume":"105","author":"Kang","year":"2021","journal-title":"Med. Clin."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"P41","DOI":"10.1016\/j.ophtha.2015.10.053","article-title":"Primary Open-Angle Glaucoma Preferred Practice Pattern\u00ae Guidelines","volume":"123","author":"Prum","year":"2016","journal-title":"Ophthalmology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"P71","DOI":"10.1016\/j.ophtha.2020.10.022","article-title":"Primary Open-Angle Glaucoma Preferred Practice Pattern\u00ae","volume":"128","author":"Gedde","year":"2021","journal-title":"Ophthalmology"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"P151","DOI":"10.1016\/j.ophtha.2020.10.023","article-title":"Primary Open-Angle Glaucoma Suspect Preferred Practice Pattern\u00ae","volume":"128","author":"Gedde","year":"2021","journal-title":"Ophthalmology"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1080\/13543784.2023.2279146","article-title":"Prostaglandin FP receptor agonists in the treatment of glaucoma and ocular hypertension: A literature review","volume":"32","author":"Moshegov","year":"2023","journal-title":"Expert. Opin. Investig. Drugs"},{"key":"ref_8","first-page":"1","article-title":"Prostaglandin analogues for the treatment of glaucoma: From the \u2018wonder\u2019 drug of the \u201890s to the reality of the 21st century","volume":"97","author":"Teus","year":"2022","journal-title":"Arch. Soc. Esp. Oftalmol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1080\/13543784.2018.1526279","article-title":"Investigational drugs targeting prostaglandin receptors for the treatment of glaucoma","volume":"27","author":"Matsou","year":"2018","journal-title":"Expert Opin. Investig. Drugs"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1920","DOI":"10.4103\/ijo.IJO_2239_21","article-title":"Newer advances in medical management of glaucoma","volume":"70","author":"Mohan","year":"2022","journal-title":"Indian J. Ophthalmol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e16526","DOI":"10.1097\/MD.0000000000016526","article-title":"Efficacy of travoprost for the treatment of patients with glaucoma","volume":"98","author":"Zhang","year":"2019","journal-title":"Medicine"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.ophtha.2015.09.005","article-title":"Comparative effectiveness of first-line medications for primary open-angle glaucoma: A systematic review and network meta-analysis","volume":"123","author":"Li","year":"2016","journal-title":"Ophthalmology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1016\/j.ajo.2015.04.041","article-title":"Polyquaternium-1-preserved travoprost 0.003% or benzalkonium chloride-preserved travoprost 0.004% for glaucoma and ocular hypertension","volume":"160","author":"Peace","year":"2015","journal-title":"Am. J. Ophthalmol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1038\/s41433-021-01668-x","article-title":"Ocular benzalkonium chloride exposure: Problems and solutions","volume":"36","author":"Goldstein","year":"2022","journal-title":"Eye"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.jtos.2024.08.001","article-title":"Preservatives and ocular surface disease: A review","volume":"34","author":"Kahook","year":"2024","journal-title":"Ocul. Surf."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Ka\u0161telan, S., Tomi\u0107, M., Soldo, K.M., and Salopek-Rabati\u0107, J. (2013). How ocular surface disease impacts the glaucoma treatment outcome. BioMed Res. Int., 2013.","DOI":"10.1155\/2013\/696328"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1497","DOI":"10.1136\/bjophthalmol-2017-311544","article-title":"Preservatives in glaucoma medication","volume":"102","author":"Steven","year":"2018","journal-title":"Br. J. Ophthalmol."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Kemer, \u00d6.E., Mekala, P., Dave, B., and Kooner, K.S. (2024). Managing ocular surface disease in glaucoma treatment: A systematic review. Bioengineering, 11.","DOI":"10.3390\/bioengineering11101010"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1080\/14740338.2021.1873947","article-title":"The treatment of glaucoma using topical preservative-free agents: An evaluation of safety and tolerability","volume":"20","author":"Konstas","year":"2021","journal-title":"Expert. Opin. Drug Saf."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.ejpb.2023.03.007","article-title":"Influence of BAKs on tear film lipid layer: In vitro and in silico models","volume":"186","author":"Saija","year":"2023","journal-title":"Eur. J. Pharm. Biopharm."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1016\/j.preteyeres.2010.03.001","article-title":"Preservatives in eyedrops: The good, the bad and the ugly","volume":"29","author":"Baudouin","year":"2010","journal-title":"Prog. Retin. Eye Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1007\/s40261-014-0203-4","article-title":"Preservative-free latanoprost eye drops in patients with primary open-angle glaucoma\/ocular hypertension","volume":"34","author":"Sanford","year":"2014","journal-title":"Clin. Drug Investig."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"3019","DOI":"10.1007\/s12325-021-01731-9","article-title":"Preserved versus preservative-free latanoprost for the treatment of glaucoma and ocular hypertension: A post hoc pooled analysis","volume":"38","author":"Harasymowycz","year":"2021","journal-title":"Adv. Ther."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Kim, K.E., Lee, C.K., Shin, J., Kim, Y., and Rho, S. (2023). Comparisons of efficacy and safety between preserved and preservative-free brimonidine tartrate in glaucoma and ocular hypertension: A parallel-grouped, randomized trial. Sci. Rep., 13.","DOI":"10.1038\/s41598-023-31726-1"},{"key":"ref_25","first-page":"613","article-title":"Efficacy, safety, and improved tolerability of travoprost BAK-free ophthalmic solution compared with prior prostaglandin therapy","volume":"2","author":"Henry","year":"2008","journal-title":"Clin. Ophthalmol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2085","DOI":"10.2147\/OPTH.S112711","article-title":"Efficacy and tolerability of benzalkonium chloride-free travoprost in glaucoma patients switched from benzalkonium chloride-preserved latanoprost or bimatoprost","volume":"10","author":"Hubatsch","year":"2016","journal-title":"Clin. Ophthalmol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1097\/IJG.0b013e3181fc8129","article-title":"Long-term effect of BAK-free travoprost on ocular surface and intraocular pressure in glaucoma patients after transition from latanoprost","volume":"21","author":"Aihara","year":"2012","journal-title":"J. Glaucoma"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1046\/j.1475-1313.1999.00420.x-i1","article-title":"Validation of grading scales for contact lens complications","volume":"21","author":"Efron","year":"2001","journal-title":"Ophthalmic Physiol. Opt."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e222","DOI":"10.1097\/OPX.0000000000000542","article-title":"Ocular surface disease in glaucoma: Effect of polypharmacy and preservatives","volume":"92","author":"Ramli","year":"2015","journal-title":"Optom. Vis. Sci."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1337","DOI":"10.1080\/14737167.2025.2556693","article-title":"Cost-utility analysis of latanoprost unidose cationic emulsion preservative-free versus latanoprost unidose in the treatment of open-angle glaucoma and ocular hypertension patients in Spain","volume":"25","author":"Canut","year":"2025","journal-title":"Expert Rev. Pharmacoeconomics Outcomes Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1136\/bjo.86.4.418","article-title":"Prevalence of ocular symptoms and signs with preserved and preservative free glaucoma medication","volume":"86","author":"Pisella","year":"2002","journal-title":"Br. J. Ophthalmol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"3501","DOI":"10.1007\/s12325-022-02166-6","article-title":"Switching to preservative-free tafluprost\/timolol fixed-dose combination in the treatment of open-angle glaucoma or ocular hypertension: Subanalysis of data from the VISIONARY Study according to baseline monotherapy treatment","volume":"39","author":"Oddone","year":"2022","journal-title":"Adv. Ther."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"3181","DOI":"10.2147\/OPTH.S382497","article-title":"Tolerability in glaucoma patients switched from preserved to preservative-free prostaglandin-timolol combination: A prospective real-life study","volume":"16","author":"Pauk","year":"2022","journal-title":"Clin. Ophthalmol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1757","DOI":"10.1007\/s00417-010-1397-7","article-title":"Comparison of the efficacy and tolerability of preservative-free and preservative-containing formulations of the dorzolamide\/timolol fixed combination (COSOPT\u2122) in patients with elevated intraocular pressure in a randomized clinical trial","volume":"248","author":"Shedden","year":"2010","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1136\/bjophthalmol-2012-303040","article-title":"Bimatoprost 0.03% preservative-free ophthalmic solution versus bimatoprost 0.03% ophthalmic solution (Lumigan) for glaucoma or ocular hypertension: A 12-week, randomised, double-masked trial","volume":"97","author":"Day","year":"2013","journal-title":"Br. J. Ophthalmol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1136\/bjophthalmol-2013-304064","article-title":"Bimatoprost 0.03%\/timolol 0.5% preservative-free ophthalmic solution versus bimatoprost 0.03%\/timolol 0.5% ophthalmic solution (Ganfort) for glaucoma or ocular hypertension: A 12-week randomised controlled trial","volume":"98","author":"Goldberg","year":"2014","journal-title":"Br. J. Ophthalmol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"75","DOI":"10.4274\/tjo.galenos.2019.29000","article-title":"Correlation of ocular surface disease and quality of life in Indian glaucoma patients: BAC-preserved versus BAC-free travoprost","volume":"50","author":"Kumar","year":"2020","journal-title":"Turk. J. Ophthalmol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"3109","DOI":"10.2147\/OPTH.S264984","article-title":"Ocular surface changes after switching from other prostaglandins to tafluprost and preservative-free tafluprost in glaucoma patients","volume":"14","author":"Ruangvaravate","year":"2020","journal-title":"Clin. Ophthalmol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"3825","DOI":"10.1007\/s10792-021-01947-2","article-title":"Comparison of BAK-preserved latanoprost and polyquad-preserved travoprost on ocular surface parameters in patients with glaucoma and ocular hypertension","volume":"41","author":"Muz","year":"2021","journal-title":"Int. Ophthalmol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1599","DOI":"10.1038\/s41433-025-03646-z","article-title":"A phase III study comparing preservative-free latanoprost eye drop emulsion with preserved latanoprost in open-angle glaucoma or ocular hypertension","volume":"39","author":"Baudouin","year":"2025","journal-title":"Eye"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Czumbel, N., Acs, T., Bator, G., Halmosi, A., Egorov, E.A., and Maltsev, D.S. (2024). A phase III, multicentre, randomised, investigator-masked, cross-over, comparative, non-inferiority trial evaluating the efficacy and tolerability of generic preservative-free Latanoprost (Polpharma, S.A.) compared to Xalatan\u00ae (Pfizer) in patients with ocular hypertension or primary open-angle glaucoma. BMC Ophthalmol., 24.","DOI":"10.1186\/s12886-024-03579-3"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"2589","DOI":"10.1007\/s11845-024-03704-7","article-title":"Comparing the tolerability of preservative-free tafluprost versus preserved latanoprost in the management of glaucoma and ocular hypertension\u2014An observer blinded active-control trial","volume":"193","author":"Brinkman","year":"2024","journal-title":"Ir. J. Med. Sci."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1080\/14740338.2023.2252341","article-title":"COMfort Eye Trial (COMET) results\u2014A non-inferiority, randomized, investigator-masked, two-parallel group, phase III clinical trial, to evaluate the efficacy and safety of a preservative free formulation of latanoprost versus a reference drug (Xalatan\u00ae) in patients with primary open-angle glaucoma (POAG) or ocular hypertension (OHT)","volume":"23","author":"Kandarakis","year":"2024","journal-title":"Expert Opin. Drug Saf."}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/15\/12\/1870\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T09:33:17Z","timestamp":1765186397000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/15\/12\/1870"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,6]]},"references-count":43,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["life15121870"],"URL":"https:\/\/doi.org\/10.3390\/life15121870","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,6]]}}}