June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Artificial tear substitutes and ocular surface in glaucoma patients with chronic treatment
Author Affiliations & Notes
  • Michele M Iester
    DiNOGMI, University Eye Clinic of Genoa, Genova, Italy
  • Michele Figus
    University of Pisa, Eye Clinic, Pisa, Italy
  • Paolo Fogagnolo
    University of Milan, San Paolo Hospital, Milan, Italy
  • Paolo Frezzotti
    University of Siena, Eye Clinic, Siena, Italy
  • Francesco Oddone
    IRCCS Fondazione G.B.Bietti, Glaucoma Unit, Britannic Hospital , Rome, Italy
  • Antonio Ferreras
    University of Zaragozza, Eye Clinic, Zaragozza, Spain
  • Footnotes
    Commercial Relationships   Michele Iester, None; Michele Figus, None; Paolo Fogagnolo, None; Paolo Frezzotti, None; Francesco Oddone, None; Antonio Ferreras, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 4600. doi:
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      Michele M Iester, Michele Figus, Paolo Fogagnolo, Paolo Frezzotti, Francesco Oddone, Antonio Ferreras; Artificial tear substitutes and ocular surface in glaucoma patients with chronic treatment. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4600.

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

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Purpose : Long-term use of preserved anti-glaucoma eye drops may affect ocular surface health. Benzalkonium chloride (BAK), the most commonly used preservative in ophthalmic solutions, has a broad range of adverse effects. The aim of the study was to assess the citoprotective effect of different artificial tear substitutes on ocular surface disease (OSD) induced by preserved prostaglandins eye drops.

Methods : Prospective, observational, multicentre, open label study. We enrolled 60 POAG patients treated with a preserved prostaglandins eye drops with OSD clinical signs detected by an Oxford score >8 after fluorescein/lissamine green staining (Oxford score grading 0-15). OSDI questionnaire, BUT, Schirmer test, fluorescein and lissamine green staining by oxford score were performed at baseline (T0) and then repeated 7 days (T7) and 30 days (T30) after preservative free tear substitutes administration. At T0 patient were randomly assigned to a TID four week treatment with a cytoprotective tear substitute: Threalose/Hyaluronic acid solution [Group A] or Coenzyme Q10/ vitamine E / Hypromellose solution [Group B]. A third group received 0,9% saline solution TID for four week [Group C]. Oxford Score reduction was considered the primary study endpoint.

Results : Oxford score and OSDI decreased in all groups vs baseline (p<0.001). In Oxford score a statistically significant difference (p<0.05) was observed only between group A and C (delta vs T0 - 4,8 vs -3,0 respectively). OSDI score decrease: group A (-19,3) and B (-16,0) > group C (-8,0)(p<0,05). No statistically significant difference was found between group A and B.

Conclusions : In OSD due to preserved anti-glaucoma treatment, cytoprotective tear substitutes (Threalose/Hyaluronic acid and Q10/vitE/Hypromellose ) provide a better efficacy than 0,9% saline solution for sign and symptoms relief.

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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