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Prevalence of preservatives in post-cataract surgery drops may increase complications
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LOS ANGELES — After cataract surgery, patients with ocular surface disease may have increased postoperative issues with wound healing, comfort and vision recovery if topical therapies contain preservatives, according to a speaker here.
“Nearly all topical ophthalmic drops contain preservatives. As you can see, the most common is benzalkonium chloride, or BAK. Due to its biochemistry, BAK has surfactant properties and works like a detergent in dissolving the bacterial walls. It is unfortunately not discriminatory between healthy cells and bacteria, and therefore can cause collateral damage,” Jamie Lynne Metzinger, MS, MPH, said at the American Society of Cataract and Refractive Surgery meeting.
Jamie Lynn Metzinger
Clinical studies have shown that BAK can have a toxic effect on the ocular surface after just 3 days of exposure, she said.
Preservative-free diclofenac scores for patients undergoing cataract surgery remained constant for ocular stability scores, while preserved diclofenac and ketorolac caused increased stinging in patients, she said.
“We know these therapies are efficacious, but we need to have increased conversation around the effects of preservatives on the ocular surface. We should consider treatment with newer-generation preparations containing no or low-risk preservation to reduce the preservative load on the ocular surface,” Metzinger said. – by Robert Linnehan
Reference:
Metzinger JL. Preservatives in topical ophthalmic medications used after ocular surgery. Presented at: American Society of Cataract and Refractive Surgery annual meeting; May 5-9, 2017; Los Angeles.
Disclosure: Metzinger reports she is a full-time employee for Ocular Therapeutix and a former employee of Shire.