Comparing anatomical pattern of topical anti-glaucoma medications associated lacrimal obstruction with a control group.
OBJECTIVE
To compare the anatomical pattern of lacrimal drainage system obstruction (LDSO) associated with topical anti-glaucoma medications (AGM) with a control group.


METHODS
In a cross-sectional controlled study, case group included patients on topical anti-glaucoma medications and control group included patients with no history of glaucoma, free of ocular disease, and not using topical medications. Data recording, eye examination, and categorization of patients into case and control groups were performed by a senior ophthalmology resident. Diagnostic probing and irrigation test was performed by an oculoplastic surgeon who was masked to the patients' data. Chi-square (X(2)) and tests were used to assess the effect of sex and systemic diseases, as well as logistic regression analysis with intra-cluster correlation for the effect of topical anti-glaucoma medications on lacrimal drainage system, and then independent sample t-tests to compare the mean ages, plus the binary logistic regression test for the effect of increasing age on LDSO.


RESULTS
There were 128 eyes of 96 patients in the case and 277 eyes of 172 patients in the control group. Two groups were similar regarding to the age, sex, and associated systemic disorders (0.3<P<0.5). There was a significantly more LDSO in the case than control group (P = 0.008). Upper LDSO was observed in 76.92% (20/26) of the cases, and 37.5% (9/24) of the control group (P = 0.01). Nasolacrimal duct obstruction was also found in 19.23% of case group.


CONCLUSIONS
Although punctum and canaliculus are the main anatomical sites of LDSO associated with topical AGM, common canaliculus and nasolacrimal duct separately or in association with punctum and canaliculus may also be involved.
Kashkouli
Mohsen Bahmani
MB
Iran University Eye Research Center, Rassoul Akram Hospital, Tehran, Iran. bahmanik@yahoo.com
Pakdel
Farzad
F
Hashemi
Masih
M
Ghaempanah
Mohammad Jafar
MJ
Rezaee
Reza
R
Kaghaz-Kanani
Reza
R
Ahadian
Ali
A
D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D005260:Female; D005901:Glaucoma / Q000188:drug therapy*; D006801:Humans; D007767:Lacrimal Duct Obstruction / Q000139:chemically induced* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D009301:Nasolacrimal Duct / Q000187:drug effects* / Q000473:pathology; D009883:Ophthalmic Solutions / Q000009:adverse effects*; D055815:Young Adult
D000959:Antihypertensive Agents; D009883:Ophthalmic Solutions