Short-term effect of topical antiglaucoma medication on tear-film stability, tear secretion, and corneal sensitivity in healthy subjects

Abstract

Background:The purpose of this study was to investigate the short-term effect of topical antiglaucoma medication on tear-film stability, tear secretion, and corneal sensitivity in healthy subjects.Methods:In this prospective, double-blind crossover trial, break-up time and basal secretion (Jones test) were measured 60 minutes before, and 30, 60, and 90 minutes after topical antiglaucoma drop application in 30 healthy subjects. Corneal sensitivity was measured 60 minutes before, and five, 10, and 15 minutes after drop application using a Cochet–Bonnet esthesiometer.Results:Reduction of break-up time in the latanoprost group was −23.8% after 30 minutes (P = 0.21), −26.7% after 60 minutes (P = 0.03) and −51.4% after 90 minutes (P ≤ 0.003), which was statistically significant. Reduction of break-up time in all other treatment groups was not statistically significant. The Jones test revealed a significant reduction of basal secretion after application of brimonidine (−17.8%, P = 0.002; −22.5%, P < 0.001; −30.5%, P < 0.001), followed by apraclonidine (−10%, P = 0.06; −20.1%, P = 0.02; −22.1%, P = 0.002), latanoprost (−2.4%, P = 0.64; −18.6%, P = 0.001; −20.1%, P = 0.001) and dorzolamide (−0.5%, P = 0.9; 14.3%, P = 0.018; −17.3%, P = 0.004) at 30, 60, and 90 minutes after drop application. Reduction of basal secretion in all other treatment groups was not statistically significant.Conclusion:Latanoprost showed the most statistically significant reduction in break-up time, and brimonidine showed the most significant reduction in basal secretion of all the glaucoma medications used in this study. In conclusion, our data may be helpful for treatment decisions in glaucoma patients who also suffer from ocular surface problems.

How Ocular Surface Disease Impacts the Glaucoma Treatment Outcome

“…Even short-term use of topical glaucoma medications in healthy persons may have deleterious effect on the ocular surface such as reducing corneal sensitivity, tear film stability, or basal secretion [17]. Furthermore in patients with preexisting OSD prolonged topical glaucoma medication treatment additionally deteriorates symptoms [18].…”

Glaucoma therapy and ocular surface disease

“…The disruptive effects of topical glaucoma medications on tear film integrity are well known [13,14 & , [15][16][17]. Objective measures of tear-film break-up time (TBUT), Schirmer's test, osmolarity, and meibomian gland score have been used to assess tear-film functionality of patients on long-term and short-term therapy.…”

Selective laser trabeculoplasty as replacement therapy in medically controlled glaucoma patients

“…Ocular hypotensive drugs are typically the first line of therapy for glaucoma. A toxic effect on the anterior eye segment has been demonstrated for the preservative, most often benzalkonium chloride (Baudouin 2008;Terai et al 2011), as well as for the active components of the antiglaucoma drops (Terai et al 2011). A toxic effect on the anterior eye segment has been demonstrated for the preservative, most often benzalkonium chloride (Baudouin 2008;Terai et al 2011), as well as for the active components of the antiglaucoma drops (Terai et al 2011).…”