Which factor have more adverse effect on ocular surface of patients treated with antiglaucoma drops; drug type, number of drugs or drug intensity?

Purpose: To examine effects of topical antiglaucoma drops on ocular surface (OS)and meibomian glands(MG) in relation to drug type, number of drugs and drug intensity.

Methods: This was a cross-sectional case study of 93 patients with glaucoma treated with topical anti-glaucoma drugs for more than 1 year. According to drug type we formed two groups; Group 1: Prostaglandin containing drops(monotherapy and combination therapy), Group 2:Non -PGA therapy.According to drug number, we formed three groups; Group 1:One active drug compound, Group 2: Two active drug compounds, Group 3:Three or more active drug compounds.We formed 2 groups accrding to drug intensity index (DII); Group 1: DII was < 50, Group 2: DII ≥ 50.Conjonctival hyperemia, ocular surface staining, tear break-up time (TBUT), and eyelid signs representing meibomian gland disease (eyelid vascularity, irregularity, nature of meibum and the Marx line score) have been compared between groups.

Results: Prostaglandin containing drops group showed significantly worse results in comparison of TBUT, conjonctival hyperemia, ocular surface staining, lid margin vascularity, meibum quality, and Marx line score.Çonjonctival hyperemia, and lid margin vascularity were observed to be significantly higher in those using eye drops containing two or more active compounds.When the DII is increased only lid margin irregularity, and meibum quality are getting worse, significantly.

Conclusion: Our results showed that the main factor contrubuting to OSD and MGD were prostaglandin analog therapy as a drug type. Management of ocular surface disease in glaucomatous patients is important when trying to reduce further ocular morbidity.