Abstract
Purpose :
Evaluate if the use of lacrimal plug in patients with glaucoma treatment with latanoprost, improves the reduction of IOP in a significant way in comparison with the contralateral eye. Furthermore compare the difference of dry eye parameters (Schirmer test, time of tearful rupture and OSDI) between an eye with lacrimal plug and an eye without tearful plug.
Methods :
A series of cases where patients with POAG were included and started with latanoprost monotherapy. The right eye was chosen for the study eye, and we placed a Smart Plug® cap in the lacrimal plug. The variables were compared with the contralateral eye before starting with antihypertensive therapy and 2 months later. For de IOP a T- test was used and for dry eye parameters Wilcoxon was used.
Results :
We studied 26 patients with a mean age of 62.4 ± 13 years, with a range of 33 -84. The 80.7 % (n=21) were women while only 19.2 % (n=5) were men. The mean baseline IOP in both eyes was 17.7 mmHg up to 24 mmHg. At 2 months the difference between the eye with lacrimal plug and the eye without lacrimal plug was .60 mmHg with p 0.003. The time difference for the tear break at 2 months is also significant at P 0.007. However, there was no significant differences in the tear volume measured by Shirmer ( p 0.29 ) nor dry eye scale OSDI ( p 0.49 ) between the eye with lacrimal plug and the eye without lacrimal plug.
At 3 months we have 23 patients; 26.06% (n6=) were men and 73.94% (n=17) were woman. The average in IOP in both eyes were 14.01mmHg up to 22mmHg- At 3 months the difference between the eye with lacrimal plug and the eye without lacrimal plug was .77 mmHg. At 6 months we have 17 patients: 23.52-% (n=4) were men and 76.48% (n=13) were woman. The average in IOP in both eyes were 14.42mmHg up to 18mmHg- At 6 months the difference between the eye with lacrimal plug and the eye without lacrimal plug was .23 mmHg.
We excluded 13 patients; 3 were men and 10 were women. 5 of them had viral conjunctivits and 8 didn’t complete the follow-up.
Conclusions :
Using a lacrimal plug tear breakup time improves after 2 months and decrease 0.6 mmHg in average of IOP which is shown to be statistically significant; After 3 months IOP decreased in average 0.7 mmHg and after 6 months 0.23 mmHg; but the evolution of these patients will continue over time to asses whether this difference is clinically significant.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.