Scanning electron microscopic study on local cornea tolerance of beta-blocker eye drops with and without preservatives

The influence of beta-blockers in short- and long-term application on the epithelium of the cornea was studied in rabbits with intact tear film, concentrating not on the completeness of the drug group but on general differences. The new unpreserved beta-blocker timolol was compared on an exemplary level with the following beta-blocker formulas: (1) beta-blocker eye drops with 0.01% of the preservative benzalkonium chloride; (2) beta-blocker eye drops with 0.005% of the preservative benzalkonium chloride, and (3) beta-blocker eye drops with 0.004% of the preservative benzalkonium chloride and the tear substitute polyvinyl alcohol. Exposure time in the short-term test was 30 min, in long-term tests the time was 24 weeks. Any cell damages observed were of only minor importance and rarely of clinical relevance; however, it could be shown that micromorphological cell reactions differed as a function of the preservative concentration. Complete absence of preservatives causes no difference in micromorphologically relevant changes in comparison with the control group. Drugs without preservatives are thus a meaningful alternative for patients with allergies, sensitive eyes or existing impairment of the precorneal film.