Multiple glaucoma med regimens increase corneal epithelial damage

Patients taking multiple glaucoma medications demonstrated more corneal epithelial damage than those taking a single medication in a study in Japan. The authors concluded that patients on multiple medications may develop more keratoepitheliopathy because of tear volume reduction and tear film instability.

Kenji Inoue, MD, PhD, and colleagues at Nadagaya Hospital in Chiba, Japan, studied 193 eyes of 110 glaucoma patients to determine the presence and severity of keratoepitheliopathy. Ocular factors assessed included the status of the lipid layer of the tear film, tear volume and tear film stability.

The overall occurrence of superficial punctate keratitis was 29%. Superficial punctate keratitis was more frequently observed in patients who used two or more glaucoma medications than in those who used one drop or no drops. Superficial punctate keratitis was more frequent in patients who used timolol (46.2%) than in those who used carteolol (4.2%). The severity of the disease and breakup time in patients who used timolol were significantly worse than in those who used carteolol. No differences were seen in ocular factors and keratoepitheliopathy between patients who used latanoprost and unoprostone.

The study is published in the December issue of Journal of Glaucoma.