Management of ocular hypertension in patients with ocular surface disease
Glaucoma and dry eye disease (DED) symptoms commonly occur together. It is estimated that 60% of glaucoma patients have symptoms of ocular surface disease (OSD).1 The prolonged use of benzalkonium chloride (BAK) preserved glaucoma eye drops was demonstrated to both induce and worsen DED signs and symptoms.
Thus, in an attempt to improve glaucoma patients' quality-of-life and treatment compliance BAK-free and soft preserved eye drops were developed. While these new formulations were better tolerated they do not protect or help in the restoration of the diseased ocular surface of glaucoma patients with OSD.
These oil nanodroplets through their interactions with the negatively charged ocular surface epithelium help improve the spreading and residence time of the eye drop. These interactions contribute in the stabilization of the tear film, as measured by an increased tear film break-up time (TFBUT) in DED patients treated with Cationorm (Novagali Pharma, Evry, France), an artificial tear cationic oil-in-water nanoemulsion.2
Catioprost (Novagali Pharma) is a preservative-free cationic oil-inwater nanoemulsion in which the oil nanodroplets are loaded with latanoprost (0.005%). Nonclinical studies demonstrated that this treatment option is as effective as Xalatan (Pfizer Inc., New York, USA) in a monkey model of elevated intraocular pressure (IOP), and very well tolerated by the rabbit ocular surface; with a 42% reduction in hyperaemia incidence when compared to Xalatan.3
Thus, cationic oilinwater nanoemulsions are not only very well tolerated by the ocular surface, but they also appear to contribute positively in the healing process of diseased corneal epithelium. Hence, Catioprost should be of particular interest for the treatment of glaucoma or ocular hypertension in patients suffering from OSD, and should be at least as good as - if not better - than BAKfree antiglaucoma therapies.