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Serena Telani, Michele Iester, Paolo Frezzotti, Michele Figus, Paolo Fogagnolo, Andrea Perdicchi, Antonio Ferreras, Carlo Enrico Traverso, beta-blocker study group; Ocular Surface Changes in Glaucomatous Patients Treated with and without Preservatives beta-Blockers. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5427.
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To determine whether there were ocular surface changes in glaucomatous patients treated with preservatives beta-blockers who switched to preservative-free beta-blockers.
This was prospective and longitudinal study. 132 patients with POAG treated with a preserved beta blocker were enrolled. All the patients underwent perimetric and gonioscopic examination, complete ophthalmologic examination, IOP measurements, evaluation of ocular surface, Schirmer test, blood pressure and heart rate at baseline and 1-3 months after changing medical treatment to a preservative-free timolol 0.1% (Timogel 0.1, Thea). At baseline and at the end of the study, all patients underwent the Ocular Surface Disease Index (OSDI) questionnaire. Data were analyzed by t test when the distribution of the data was normal, by Mann-Whitney when the distribution was not-normal.
No significant difference was found for IOP before switching from preserved beta-blockers to preservative-free ones. No significant difference was found in blood pressure and heart rate. However a statistically significant difference was found for abnormal fluorescein staining of cornea and conjunctiva, eyelid erythema, conjunctival hyperaemia and follicular hyperplasia. A significant difference was found for break-up time (from 9.38 ± 4.7 sec at baseline to 10.64 ± 4.7 after 3 months) and Schirmer’s test (from 12.9 ± 5.96 mm at baseline to 14.2 ± 5.87 mm after 3 months). OSDI questionnaire showed that the patient improved the dryness and foreign body sensation.
Preservative-free timolol 0.1 treatment maintained IOP at the same level of the other beta-blockers, but it was better tolerated in patients having signs or symptoms while on preserved beta blockers. Preservative-free treatment improved the quality of life reducing dryness, hyperaemia, follicular hyperplasia and foreign body sensation.
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