EyeWorld India June 2015 Issue

58 EWAP PHARMACEUTICALS June 2015 alternative medications that have softer preservatives or single-dose preservative-free medication, he noted. “Although they still can have some effect on the ocular surface, these aren’t quite as harsh as the medications with BAK,” Dr. Kammer said. Dr. Parekh concurred that sometimes the alternatively preserved and preservative-free agents can help. Such agents include Travatan Z (travoprost, Alcon, Fort Worth, Texas) preserved with SofZia, Alphagan P (brimonidine tartrate, Allergan, Irvine, Calif.) with Purite, and preservative-free medications such as Timoptic in Ocudose (timolol, Bausch + Lomb, Bridgewater, NJ), Cosopt PF (dorzolamide/timolol, Merck, Whitehouse Station, NJ), and Zioptan (tafluprost, Merck). Dr. Kammer finds that the alternatively preserved agents can be more benign than agents with traditional preservatives. “They’re distinguished by these alternative preservatives, which in several clinical studies have been shown to be less toxic to the ocular surface,” he said, adding that theoretically this can have a positive impact on how people feel on a daily basis and on how they see. He pointed out that practitioners are fortunate to have single-dose, preservative-free drops from three different categories of glaucoma medication—Cosopt PF, a combination beta-blocker and carbonic anhydrase inhibitor, preservative-free Timoptic in Ocudose, a beta-blocker, and preservative-free Zioptan, a prostaglandin analogue. This is something that he views as a real Scanning - from page 57 boon for patients. The great thing about this is you can put patients on three different glaucoma medications with no preservatives, Dr. Kammer noted. “So for patients who have significant dry eye symptoms, this can be very beneficial and can make a difference between whether or not they need a surgical procedure or can continue with medication,” he said. Looking to the future, there are already some new options in the wings. Among these, Dr. Kammer pointed to an implantable extended-release device that releases microparticles and nanoparticles as one potential new option. Use of micro-needles to inject medication into a specific spot is another, he said. Clinical trials are underway for an intracameral medication that could lower the intraocular pressure. “These options could be helpful to these patients who have significant dry eye symptoms and other ocular surface diseases,” Dr. Kammer said. Dr. Parekh agreed that an injectable or a longer-lasting glaucoma medication would be great for circumventing ocular surface issues. However, in his view the “holy grail” would be the advent of a whole new class of glaucoma drugs. EWAP Editors’ note: Dr. Kammer has financial interests with Allergan and Iridex (Mountain View, Calif.). Dr. Parekh has financial interests with Alcon, Allergan, and Bausch + Lomb. Contact information Kammer: jeff.kammer@vanderbilt.edu Parekh: parag2020@gmail.com Friday, 7 Aug 2015 • 17:30hrs Hall 3, Kuala Lumpur Convention Centre