Is BAK preservative a problem in Patanol?

[TARYN]

I have been reading the threads about BAK. I use Patanol twice a day. Will the BAK cause a problem in my eyes? No problems as of yet.

[neil0502]

Patanol is preserved with Benzalkonium Chloride 0.01% [1]

I dunno, Taryn. Each has to make this decision for his/her self, in conjunction with the doc's, BUT ...

1) I'm never (knowingly) putting it in my eye again;

2) It DOES damage the cornea. Period. More so in dry eye patients. Can your eye take it? Can your eye recover without symptoms? I don't know;

3) If there's a reasonable substitute--either preserved with something else or preservative free--do you want to take the chance?

Did you take a look at a few of those links? I'm happy to summarize anything I can for you, but ... better would be if you're able to process it AND discuss it with your doctor.

All the best,
Neil

[1] http://a1020.g.akamai.net/7/1020/222...anol_us_en.pdf

EDIT: I think this study is pretty digestible...

http://www.aios.org/proceed2003/External/Ext11.pdf

[Flick]

Wow, I didn't realize that BAK could cause so much damage. That's a pretty thorough study.

I was hoping to go on steroids (Lotremax) for a while to try and reduce inflammation. Now, I'm not so sure, since it is preserved with, guess what, Benzalkonium Chloride.

Anyone know of a way to get non-preserved steroids?

It's kinda scary that most people that are post-Lasik are prescribed ocular steroids, which could actually be making their dry eye worse.

[neil0502]

Yeah, Flick. Yeah.

I'm telling you: the literature is chock full of this kind of info. I can't believe more hasn't been done, though I suspect it's moving that way quickly.

As to sources of preservative free: I would suggest reaching out to the compounding pharamacies to see what they can do. I got my HA and Castor Oil drops from Leiter. Chuck Leiter has been extremely helpful and cordial.

http://www.leiterrx.com

http://www.ucprx.com/

http://www.iacprx.org/

http://www.apothecure.com/

[sazy123]

I just think its outragous that dry eye products are sold with that BAC stuff in it. really makes me angry Theres quite a few dry eye drops with BAC in it that you can buy OTC or percription artifical tears in the UK.

I went to the chemmist and asked for celluvisc eye drops (non presevered) once, and they werent sure they had them and offered me two different drops with BAC in them (cant remember what they were now) i just said i cant have them becuase the BAC preservative is not good for dry eye. They must of thought i was weird becuase they are DRY EYE products! really enoys me, that they can sell this stuff, becuase the unexpecting elderly wont think nothing of it!!!!

[neil0502]

I'm reviving an old thread to provide some additional information ... that supports what I'd always guessed.

It seems that BAK, is--indeed--toxic to the cornea, BUT ... HOW toxic depends on the drop that it's preserving. Here's an interesting study that makes that point [1].

The bottom line of this and similar studies is: SOME drugs do a better job of providing inherent protection TO the eye AGAINST the ill effects of BAK. Some TYPES of drops (anti-glaucoma vs. steroid vs. decongestant, etc) will be worse than others; some formulations WITHIN each TYPE will, similarly be worse than others. It's a great unknown, generally.

Unfortunately, even the use of BAK in the sort of drops that most of US use a) is untested in terms of damage (as far as I know), and b) presents a risk.

Analogy: If somebody told you that they put a drop of rat poison in a glass, but ... that the glass was full of water, so it should be nicely diluted ... would you drink that glass of water?

Not me.

[1] http://www.ncbi.nlm.nih.gov/entrez/q..._uids=16303954

CONCLUSIONS: Latanoprost and travoprost were responsible for significant protective effects against BAC toxicity on conjunctiva-derived epithelial cells in vitro, probably related to their antioxidative properties. The low toxicity of the bimatoprost solution did not reveal a possible antioxidative effect. Reduced reactive oxygen species production could be the main mechanism by which prostaglandin analogs protect epithelial cells from the proapoptotic effects of BAC. Further studies will be useful to confirm this hypothesis.

[DESTINY]

Flick

I get my non preserved steroids from Dr. Tseng at the Ocular Surface center. He makes Dexamethasome at his office and you have to keep it in the refrigerator. The shelf life is about a month( in the refrigerator ) otherwise it will only last a week.

It is kind of pricey though... about $45.00 a bottle and then you have to pay for shipping and the shipping is expensive because it is shipped in dry ice. I think the shipping is about $60.00 to $80.00 also. I know it is expensive but soooooooo worth it!!

I too was using BAC steroids for a while and noticed that my eyes were getting worse and worse! After reading posts on this forum I realized why. Thank you all for all of your literature relating to BAC it was really helpful with my eye problems!

Since using the preservative free steroids I have noticed that my eyes look and feel alot better. That coupled with AM surgery, Restasis, Punctul plugs, Cautery,Tea Tree Oil scrubs and Omega 3's!!! Huh...... Not sure whats working but whatever the case I staying on the bus that I am on! I hope this helps you!

Destiny