[Approaches for improvement of ocular surface condition in primary open-angle glaucoma].

Abstract

Purpose: This study compares the effectiveness of various approaches to improvement of ocular surface condition in primary open-angle glaucoma (POAG) patients with dry eye syndrome (DES) and meibomian gland dysfunction (MGD).

Material and methods: The study included 48 patients with stage II POAG, compensated with a fixed-combinations of dorzolamide and timolol (FC-DT) containing benzalkonium chloride (BAC), in the presence of DES and MGD. After randomization, patients in group 1 (n=24) received FC-DT without BAC along with eyelid hygiene ("Blepharogel cleansing", "Blepharolotion", "Blepharogel-1"), while patients in group 2 received only FC-DT without BAC. The control points (CP) were: 1 - at baseline, 2 - after 4 weeks of therapy. Changes in OSDI score, tear break-up time (TBUT), Bijsterveld's xerosis index (XI), MGD severity, and intraocular pressure (IOP) were assessed at each CP.

Results: By the second CP, in group 1 significant improvements were observed in OSDI, TBUT, XI, and MGD severity by the 2nd CP, while in group 2 - in OSDI and TBUT. The improvements in OSDI and TBUT were significantly more pronounced in group 1, likely due to the reduction in MGD severity. The changes in IOP in both groups were insignificant.

Conclusion: In patients with POAG, DES, and MGD who are undergoing therapy with BAC-containing medications, an approach involving switching to BAC-free eye drops combined with eyelid hygiene (using "Blepharogel cleansing", "Blepharolotion", and "Blepharogel-1") proved to be more effective than the approach of switching to BAC-free medications without additional eyelid hygiene.