Adverse effects of topical antiglaucoma drugs on the ocular surface.
OBJECTIVE
This study was designed to determine the effect of long-term antiglaucoma topical medication on the ocular surface; measuring basal Schirmer's and tear break-up time tests using conjunctival impression cytology.


METHODS
The ocular surfaces of 30 control subjects (group 1), 24 primary open-angle glaucoma patients treated with 0.5% betaxolol hydrochloride (group 2), 27 primary open-angle glaucoma patients treated with 0.5% timolol maleate (group 3) and 26 primary open-angle glaucoma patients treated with 0.5% betaxolol and 1% dipivefrin hydrochloride (group 4) were evaluated. Basal Schirmer's and tear break-up time tests were measured and ocular surface changes were determined by impression cytology. Impression cytology specimens of each group were graded and scored in the range 0-3 according to Nelson's method.


RESULTS
Patients in groups 2, 3 and 4 showed statistically significant fewer normal basal Schirmer's tests (wettability) and tear break-up time tests (P < 0.01). Also, the conjunctival impression cytology scores were significantly higher in groups 2, 3 and 4 than in group 1 (P < 0.01).


CONCLUSIONS
The conclusion was that it is possible that conjunctival surface and tear film function change after the long-term use of antiglaucoma medication.
Department of Ophthalmology, Cumhuriyet University School of Medicine, Sivas, Turkey. arici@isbank.net.tr
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D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000009:adverse effects*; D000328:Adult; D000368:Aged; D015784:Betaxolol / Q000008:administration & dosage / Q000009:adverse effects*; D003228:Conjunctiva / Q000187:drug effects* / Q000473:pathology; D004837:Epinephrine / Q000008:administration & dosage / Q000009:adverse effects* / Q000031:analogs & derivatives*; D005902:Glaucoma, Open-Angle / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D008875:Middle Aged; D009883:Ophthalmic Solutions; D013499:Surface Properties / Q000187:drug effects; D013666:Tears / Q000187:drug effects*; D013999:Timolol / Q000008:administration & dosage / Q000009:adverse effects*
D000319:Adrenergic beta-Antagonists; D009883:Ophthalmic Solutions; D013999:Timolol; C015173:dipivefrin; D015784:Betaxolol; D004837:Epinephrine