Long-term use of topical intraocular pressure-lowering medications, particularly those containing preservatives, may cause or worsen ocular surface diseases, which may ultimately reduce patient tolerance and compliance, increase surgical risk, and compromise treatment efficacy.Therefore, long-term management of glaucoma requires the consideration of various factors such as efficacy, safety, and cost-effectiveness.Recently, the use of preservative-free (PF) intraocular pressure-lowering drugs has been gaining considerable attention in research as a means to avoid the toxicity of preservatives on ocular health.These drugs have similar pharmacokinetic properties and bioequivalence to their corresponding preservative-containing drugs.In addition, the manufacturing process of PF medications can reduce the incidence of ocular surface diseases, improve patient symptoms, and increase treatment effectiveness, indicating extensive potential applications.This review focuses on the development and clinical use of PF intraocular pressure-lowering drugs, aiming to deepen clinicians' understanding of their use.

Glaucoma; Intraocular pressure; Drug therapy; Preservative-free; Advances; Future prospects