Patient Satisfaction High With Preservative-Free Glaucoma Drop

Senior woman applying eye drops to her husband at home
Those with suboptimal compliance due to poor tolerability reportedly had an easier time with this option.

A “real-world study” across 6 European countries looking at patient satisfaction and tolerability reports that preservative-free latanoprost (PFL) “may be considered a valuable first-choice treatment in glaucoma patients,” according to the study, published in Clinical Ophthalmology.

Suboptimal compliance, or impaired long-term outcomes, can be caused by poor tolerability, according to the researchers. The multicenter, international, transverse, epidemiological survey study was conducted to determine satisfaction in 1872 patients receiving PFL for at least 3 months in Germany, Switzerland, Belgium, Spain, the Netherlands, and Portugal. Before receiving PFL treatment, patients were treatment naïve or currently treated for their glaucoma. Investigators found that 76.2% of patients had been previously treated, with 69.4% receiving preserved and 6.8% preservative-free (PF) topical treatment. 

Each patient completed a questionnaire concerning global satisfaction and satisfaction based on tolerability, during a single routine consultation.

Following 3 months of PFL treatment, 95.3% of patients studied were satisfied or very satisfied with their PFL treatment. In addition, patients were significantly (P <.0001) more satisfied with PFL than with their previous treatment (although approximately 4% were either unsatisfied or very unsatisfied). 

“Overall, 97.3% of originally treatment-naïve patients were satisfied (50.1%) or very satisfied (47.2%) with their PFL,” according to researchers.

In 9.2% of patients (n=173), ocular surface disease was diagnosed but was mainly mild (76.9%). “Lid redness, lid swelling, lid scale or crusts and chemosis showed no statistically significant difference between patients with preserved therapy and patients with PFL.”

The study’s limitations include the fact that it was not a comparative, randomized study, which made a direct comparison between preserved drops and PFL impossible. Additionally, “the low number of patients in the subgroups previously treated by PF glaucoma treatment (126 patients), representing only 6.8% of the overall study population compared to other sub-groups requires further investigations in order to support the benefits of PFL in glaucoma for all different patient profiles.” The third limitation, investigators report, was clinicians asked patients to estimate their treatment satisfaction but didn’t ask them for a reason for dissatisfaction, which might cause bias. 

Finally “a logistic regression was used to determine whether patient satisfaction was related to other variables. Each variable was analyzed in a separate logistic regression model as a predictor for being satisfied with PFL. With satisfaction potentially being multifactorial, the analysis was not performed with multiple comparison methods or used for adjusting the overall α-level.

Disclosure: Several study authors declared affiliations with the biotech or pharmaceutical industries. Please see the original reference for a full list of authors’ disclosures.


Erb C, Stalmans I, Iliev M, Muñoz-Negrete FJ. Real-World Study on Patient satisfaction and tolerability after switching to preservative-free latanoprost. Clin Ophthalmol. 2021;15:931–938. doi:10.2147/OPTH.S295821.