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Ocular surface concerns due to glaucoma agents may be overestimated
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Ocular surface changes caused by antiglaucoma medications in stable, medically treated, compliant patients with no dry eye history are mostly subclinical, according to researchers in Investigative Ophthalmology & Visual Science.
Villani and colleagues studied 100 consecutive patients with medically controlled primary open-angle glaucoma and 50 healthy controls, with treated patients receiving the same medical regimen without variation for 18 months before enrollment.
In medically controlled primary open-angle glaucoma, subbasal nerve length and tortuosity and dendritic cell density were increased compared to controls.
Those treated with preserved drugs had reduced tear film break-up time, and those taking agents preserved with benzalkonium chloride had reduced Schirmer’s test values, according to the study.
Lissamine green staining was increased in patients treated with two or more drugs.
The Schirmer’s test was decreased in the group treated with the higher number of daily drops, and the subbasal nerve tortuosity was lower in the group treated with two drops/da.
According to researchers, unpreserved drops may avoid the adverse effects of preservatives on the ocular surface, but they are more expensive, and the single-dose vials may be more difficult for an older patient to use.
“The clinical relevance of these changes is not clear, but the results of this study suggest that the ocular surface concerns regarding antiglaucoma medication may have been overestimated,” the researchers concluded. – by Abigail Sutton
Disclosure: Villani is a consultant for Allergan. All other authors reported no financial disclosures.
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