Preservatives in Topical Ophthalmic Medications: Historical and Clinical Perspectives

P. David Freeman; Malik Y. Kahook


Expert Rev Ophthalmol. 2009;4(1):59-64. 

In This Article

Five-year View

The recent emergence of oxidizing preservatives such as sofZia and Purite portend a future movement away from detergent preservatives and a renewed interest in the deleterious effects manifested in the eye as a consequence of chronic treatments instituted by the treating physician. Industry will continue to seek out newer agents that will preserve medications in multidose bottles while causing fewer side effects on corneal and conjunctival tissues. The use of unit-dose bottles that do not require preservatives will increase and become more cost effective while newer technologies will enable multidose bottles to be constructed to inhibit microbial invasion through inherent material properties independent of traditional preservatives. Medications with longer durations of efficacy will lead to fewer dosing events on the ocular surface, thus lessening exposure to all classes of preservatives. Finally, the use of medication depots injected into the eye or in the subconjunctival/sub-Tenon's space will allow for single applications of medication without the need for repeated dosing. Topical application of medications will remain the mainstay of treatment for ophthalmic diseases in the foreseeable future. Recognition of the ophthalmic side effects when using these agents will allow physicians to effectively treat disease while offering better care for patients.