title: Tear film and ocular surface alterations in chronic users of antiglaucoma medications.
abstract: OBJECTIVE
  Tear film can be altered by chronic medications that may disrupt the equilibrium responsible for the functioning of the lacrimal gland and ocular surface. The purpose of this study was to determine if antiglaucomatous chronic treatment induced alterations in the tear film and ocular surface.
  
  
  METHODS
  After informed consent, 21 patients using antiglaucomatous eye drops for more than 8 months and 20 age- and sex-matched volunteers without eye and systemic medications (control group) were enrolled. The data of ocular discomfort, fluorescein and lisamine green staining, tear film break-up time and Schirmer test were collected and compared by Student's t test. The impression cytology data were graded and compared by chi-square test.
  
  
  RESULTS
  Patients chronically using antiglaucomatous medications presented with significant higher fluorescein staining (p=0.003), lisamine green staining (p=0.02) and lower TFBUT (p=0.001). The other compared parameters, including impression cytology were similar between the treated and control group (p>0.05).
  
  
  CONCLUSIONS
  The present study shows that the tear film and the ocular surface are altered in patients under antiglaucomatous medications. In common, all medications were preserved with benzalkonium chloride. Efforts to minimize the adverse effects of chronic use of antiglaucomatous drugs must be addressed.
authors.affiliation: Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
authors.forename: Lina do Prado
authors.initials: Ldo P
authors.lastname: Baffa
authors.forename: Jose Reinaldo da Silva
authors.initials: JR
authors.lastname: Ricardo
authors.forename: Ana Carolina
authors.initials: AC
authors.lastname: Dias
authors.forename: Carolina Maria
authors.initials: CM
authors.lastname: Módulo
authors.forename: Alexandre Martins
authors.initials: AM
authors.lastname: Braz
authors.forename: Jayter Silva de
authors.initials: JS
authors.lastname: Paula
authors.forename: Maria de Lourdes Veronese
authors.initials: Mde L
authors.lastname: Rodrigues
authors.forename: Eduardo Melani
authors.initials: EM
authors.lastname: Rocha
mesh_terms: D000959:Antihypertensive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D016022:Case-Control Studies; D005260:Female; D005901:Glaucoma / Q000188:drug therapy*; D006801:Humans; D007765:Lacrimal Apparatus / Q000187:drug effects* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010862:Pilocarpine / Q000009:adverse effects / Q000627:therapeutic use; D012720:Severity of Illness Index; D013449:Sulfonamides / Q000009:adverse effects / Q000627:therapeutic use; D011795:Surveys and Questionnaires; D013666:Tears / Q000187:drug effects*; D013843:Thiazines / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000959:Antihypertensive Agents; D013449:Sulfonamides; D013843:Thiazines; D010862:Pilocarpine; C111827:brinzolamide