A patient with severe ocular surface disease and concurrent open-angle glaucoma requires IOP-lowering therapy. The preferred agent to minimize preservative-related ocular surface toxicity while achieving adequate IOP reduction is:
- A Timolol 0.5% with benzalkonium chloride (BAK)
- B Preservative-free tafluprost 0.0015% ✓
- C Bimatoprost 0.03% with BAK
- D Fixed combination dorzolamide-timolol with BAK
Correct answer: B. Preservative-free tafluprost 0.0015%
Explanation
BAK (benzalkonium chloride), the most common preservative in eye drops, disrupts the tear film, damages conjunctival goblet cells, and causes corneal epithelial apoptosis — worsening dry eye and ocular surface disease. Preservative-free tafluprost 0.0015% is a potent PG analogue available in unit-dose preservative-free formulations, offering equivalent IOP reduction to preserved latanoprost while minimizing ocular surface toxicity. Preservative-free dorzolamide is also available but less potent as monotherapy.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.