https://doi.org/10.30702/Ophthalmology.2019/09.105461

 Demin Yu. A.¹, Shebanov R. V.²

¹Kharkiv Medical Academy of Postgraduate Education, Kharkiv, Ukraine
²International Medical Center “Ophtalmicaˮ, Kharkiv, Ukraine

 Summary. Drug therapy is the method of first choice in glaucoma. Adverse events, that are associated with local usage of drugs, can have an effect on the patient’s adherence to prescribed treatment, the interaction between the doctor and the patient, and the quality of life. BAC (benzalkonium chloride) is the most commonly used preservative currently used in eye drops for the treatment of glaucoma. BAC is a highly effective antimicrobial preservative, but it also has a toxic effect on the cells of various structural eyes. In vitro studies, even low concentrations of BAH lead to toxic changes and apoptosis of the trabecular apparatus cells. Theoretically, long-term topical therapy with antiglaucoma drugs, in which BAC is used as a preservative, can cause of decreasing of trabecular function and worsening of glaucoma. In addition, prolonged use of drugs with BAC leads to decrease in the number of cells of the conjunctiva, disruption of the intercellular contacts of epithelial cells of the cornea with the development of their excessive desquamation, as well as epithelial metaplasia. At the cellular level, BAC induces oxidative stress, causes cell membrane lysis and protein denaturation, triggering the mechanism of apoptosis, activates and maintains the immune-inflammatory response, causing the so-called pro-inflammatory readiness of the conjunctiva and promoting the development of subconjunctival fibrosis. An alternative to antiglaucoma drops with BAC is using other, less toxic preservatives or non-preservative forms of drugs. At the beginning of 2019, the first non-preservative anti-glaucoma preparation from the group of prostaglandin analogues (prostamide), Bimikan ECO in a multi-dose vial, is available in Ukraine. The bottle of Bimikan® ECO is supplied with a special dropper, patented, as the system Novelia® produced by Nemera (France).

Keywords: glaucoma, BAC, non-preservative forms, Bimikan® ECO, Novelia® system.

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Received: 01 March 2019

Published: April 2019