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Konservierungsmittel in der Ophthalmologie

Preservatives in ophthalmology

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Zusammenfassung

Augentropfen in Mehrdosisbehältnissen müssen entsprechend dem Deutschen Arzneibuch (DAB) in angemessener Konzentration konserviert sein. Konservierungsstoffe sind zudem für die Stabilität und intraokulare Penetration von gewissen Ophthalmika notwendig. Die meisten Konservierungsmittel wirken relativ unspezifisch als Detergenzien oder durch oxidative Mechanismen und führen somit zu Nebenwirkungen an Augenoberfläche und Tränenfilm. Möglicherweise bewirken sie auch Schäden an Linse, Trabekelmaschenwerk und Netzhaut. Benzalkoniumchlorid, das am häufigsten verwendete Konservierungsmittel in Ophthalmika, ist deutlich toxischer als andere bzw. neuere Konservierungsstoffe wie Polyquaternium-1 (Polyquad), Natriumperborat, Oxychloro-Komplex (Purite®) oder SofZia. Bei Patienten mit manifestem Augenoberflächenschaden, häufiger Tropftherapie, gesicherter Konservierungsmittelallergie und Kontaktlinsentherapie ist eine unkonservierte Augentropfentherapie unumgänglich.

Abstract

Preservatives are a legal requirement for eye drops in multidose containers. Moreover, they are necessary for stabilization and intraocular penetration for a number of ophthalmic preparations. Most preservatives act in a relatively unspecific manner as detergents or by oxidative mechanisms and thereby cause side effects at the ocular surface. They may also affect the lens, trabecular meshwork and the retina. Benzalkonium chloride is the most commonly used preservative in ophthalmology and is more toxic than other or newer preservatives, such as polyquaternium-1 (Polyquad), sodium perborate, oxychloro-complex (Purite®) and SofZia. Preservative-free topical medication is highly recommended for patients with ocular surface disease, frequent eye drop administration, proven allergy to preservatives and contact lens wear.

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Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehungen hin: Berater- und Referententätigkeit für folgende Firmen: Allergan, Alcon, Bitop, MSD, Santen, Thea.

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  1. Augenklinik der Ludwig-Maximilians-Universität München, Mathildenstr. 8, 80336, München, Deutschland

    E. M. Messmer

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Messmer, E. Konservierungsmittel in der Ophthalmologie. Ophthalmologe 109, 1064–1070 (2012). https://doi.org/10.1007/s00347-012-2638-4

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