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Anne-Marie Bleau, Adriano Guarnieri, Alfonso Luis Sabater, Alvaro Velazquez Villoria, Javier Moreno-Montanes; Irreversible Effect of Topical Antiglaucomatous Therapy on the Meibomian Glands.. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5688.
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© ARVO (1962-2015); The Authors (2016-present)
To analyze the effect of antiglaucomatous eye-drops on Meibomian gland (MG) morphology and the evolution following glaucoma surgery.
Cross-sectional observational study of 200 glaucomatous patients under medical treatment with hypotensive eye-drops and 60 healthy volunteers. Also, 60 patients that underwent glaucoma surgery at least 1 year before examination and without any topical treatment were compared with glaucomatous and normal eyes. Only one eye from each patient was included and only the MG in the superior lid was evaluated. Glaucoma patients were classified according to the duration and type of antiglaucoma medication, and the number of drops administrated per day. We evaluated the MG depletion (Meibom-Pen, JFC), the tear break-up time (BUT), the Schirmer test, and keratitis using the Oxford scale.
An intense MG depletion was found in the treated group as compared to control patients (p<0.0001). In treated eyes, lower BUT values (p<0.05) and high levels of keratitis (p<0.0001) were detected. No changes were observed for the Schirmer test. A positive correlation between MG depletion and the duration of treatment (p<0.0001), the number of drugs (p<0.0001) and eye-drops/day (p <0.01), and the age of glaucomatous patients (p<0.05) were detected. The relationship was statistically significant after administration of 2 drugs (p <0.01), or 1 year of treatment (p <0.05) or one drop a day (p<0.001). In the group of glaucoma surgery, the MG depletion and BUT were at similar levels to the treated group, and lower than the control group (p<0.001). However, the keratitis was reduced compared to treated eyes (p<0.0001), reaching similar value as the control group.
Our data demonstrate an intense MG depletion related to the number of treatments and number of eye-drops administrated/day, as well as the time of treatment. This effect was not recovered after glaucoma surgery, indicating that the MG depletion is irreversible in many patients. The keratitis was reduced to normal levels after glaucoma surgery.
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