Ocular factors relevant to anti-glaucomatous eyedrop-related keratoepitheliopathy.
OBJECTIVE
To evaluate the ocular factors contributing to keratoepitheliopathy in glaucoma patients treated with or without anti-glaucomatous eyedrops, and the influences of each anti-glaucomatous eyedrop to keratoepitheliopathy.


METHODS
The presence and severity of keratoepitheliopathy was investigated in 193 eyes of 110 glaucoma patients. The ocular factors examined were the status of the lipid layer of the tear fluid as assessed by a specular reflection video-recording system, tear volume assessed by Schirmer's test, and tear film stability assessed by tear break-up time. The influences of combined anti-glaucomatous eyedrops and each anti-glaucomatous eyedrops to keratoepitheliopathy were investigated.


RESULTS
The overall occurrence of superficial punctate keratitis was 29.0%. Superficial punctate keratitis was more frequently observed in patients who used more than two anti-glaucomatous eyedrops (35.9%) than in those who used without (19.7%) and one (30.9%). Results of Schirmer's test and break-up time were worse in patients who used combined medication. The occurrence of superficial punctate keratitis in patients who used timolol (46.2%) was significantly more frequent than in those who used carteolol (4.2%). Severity of superficial punctate keratitis and break-up time in patients who used timolol were significantly worse than in those who used carteolol. There were no differences of keratoepitheliopathy and ocular factors between patients who used latanoprost and unoprostone.


CONCLUSIONS
The usage of multiple anti-glaucomatous eyedrops induces keratoepitheliopathy by reducing the tear volume and the tear film stability. Carteolol may be used more safely for corneal epithelium.
Inoue
Kenji
K
Department of Ophthalmology, Nadogoya Hospital, Chiba, Japan. inoue-k@fd5.so-net.ne.jp
Okugawa
Kazuko
K
Kato
Satoshi
S
Inoue
Yuji
Y
Tomita
Goji
G
Oshika
Tetsuro
T
Amano
Shiro
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002354:Carteolol / Q000008:administration & dosage / Q000009:adverse effects; D015237:Dinoprost / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D004359:Drug Therapy, Combination; D019573:Epithelium, Corneal / Q000378:metabolism / Q000473:pathology*; D005260:Female; D005902:Glaucoma, Open-Angle / Q000188:drug therapy*; D006801:Humans; D007634:Keratitis / Q000209:etiology* / Q000378:metabolism; D000077338:Latanoprost; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000008:administration & dosage / Q000009:adverse effects; D011461:Prostaglandins F, Synthetic / Q000008:administration & dosage / Q000009:adverse effects; D012307:Risk Factors; D013449:Sulfonamides / Q000008:administration & dosage / Q000009:adverse effects; D013666:Tears / Q000187:drug effects* / Q000378:metabolism; D013876:Thiophenes / Q000008:administration & dosage / Q000009:adverse effects; D013999:Timolol / Q000008:administration & dosage / Q000009:adverse effects
D000959:Antihypertensive Agents; D009883:Ophthalmic Solutions; D011461:Prostaglandins F, Synthetic; D013449:Sulfonamides; D013876:Thiophenes; C072630:isopropyl unoprostone; D000077338:Latanoprost; D013999:Timolol; D002354:Carteolol; C062765:dorzolamide; D015237:Dinoprost