June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Ocular lubricant use in medically and surgically treated glaucoma
Author Affiliations & Notes
  • Jayant Venkatramani Iyer
    Ophthalmology, Singapore National Eye Centre, Singapore, Singapore
    Glaucoma, Wilmer Eye Institute, Baltimore, Maryland, United States
  • Yang Zhao
    Ophthalmology, Singapore National Eye Centre, Singapore, Singapore
    Ophthalmology, National University of Singapore, Singapore, Singapore
  • Fiona Lim
    Ophthalmology, Singapore National Eye Centre, Singapore, Singapore
  • Louis Tong
    Ophthalmology, Singapore National Eye Centre, Singapore, Singapore
    Singapore Eye Research Institute, Singapore, Singapore
  • Tina T Wong
    Ophthalmology, Singapore National Eye Centre, Singapore, Singapore
    Singapore Eye Research Institute, Singapore, Singapore
  • Footnotes
    Commercial Relationships   Jayant Iyer, None; Yang Zhao, None; Fiona Lim, None; Louis Tong, None; Tina Wong, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 2665. doi:
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    • Get Citation

      Jayant Venkatramani Iyer, Yang Zhao, Fiona Lim, Louis Tong, Tina T Wong; Ocular lubricant use in medically and surgically treated glaucoma. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2665.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Chronic use of intraocular pressure (IOP) lowering medications is associated with ocular surface disease (OSD). Ocular lubricants are regularly used in management of OSD. In this study we assess the incidence of topical lubricant use as a surrogate marker for underlying OSD, in medically and surgically treated glaucoma patients over 5 years of review.

Methods : Retrospective chart review was performed for newly diagnosed glaucoma patients who were started on topical medications in 2007 and followed up over a 5-year period. Primary outcome measure was the incidence of topical lubricant use in these patients and a subset of these patients who required glaucoma or cataract surgery during followup.

Results : Charts of 505 newly diagnosed glaucoma patients with no prior history of ocular lubricant use were analyzed. Mean age was 63.9 years (SD: 11.1) and 42.8% were women. 124 (24.6%) of these patients underwent phacoemulsification surgery, 97 underwent mitomycin C (MMC) augmented phacotrabeculectomy, 25 underwent MMC-augmented trabeculectomy and 3 underwent tube surgery over the course of followup. 5-year incidence of lubricant use was 59% in all glaucoma subjects. 52.8% of patients on medical treatment and 72.9% of patients who underwent phacotrabeculectomy or trabeculectomy required lubricants respectively (p=0.005). 60.4% of glaucoma subjects who underwent phacoemulsification surgery required lubricant use. Incidence of lubricant use increased from 21.3% preoperatively to 71.3% postoperatively in subjects who required trabeculectomy or phacotrabeculectomy. Incidence of lubricant use was similar in patients on one or multiple glaucoma medications, with the mean onset of lubricant use being 10 months after starting glaucoma medication in both groups. Females were also more likely to require artificial tears compared to males (p=0.002).

Conclusions : Both medical and surgical management of glaucoma have an adverse effect on the ocular surface. Chronic use of glaucoma medications was associated with a high incidence of ocular lubricant use. MMC-augmented trabeculectomy was associated with an even higher incidence of ocular lubricant use with this surgery increasing the need for topical lubricants more than threefold postoperatively.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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