Ocular surface changes in glaucomatous patients treated with and without preservatives beta-blockers.
OBJECTIVE
To determine whether there were ocular surface changes in glaucomatous patients treated with preservatives beta-blockers who switched to preservative-free beta-blockers.


METHODS
This was a prospective, longitudinal, open-labeled study. One hundred thirty-two patients with primary open angle glaucoma treated with a preserved beta-blocker were enrolled. All the patients underwent perimetric and gonioscopic examination, complete ophthalmologic examination, intraocular pressure (IOP) measurements, evaluation of ocular surface, Schirmer's test, blood pressure and heart rate at baseline and 1-3 months after changing the medical treatment to a preservative-free timolol 0.1% (Timogel 0.1; Thea). At baseline, after 1 month and at the end of the study (3 months), all patients underwent a questionnaire on the visual quality and symptoms and on the quality of life (QoL). Data were analyzed by t-test when the distribution of the data was normal, by Mann-Whitney when the distribution was not normal.


RESULTS
No significant difference was found for IOP before switching from preserved beta-blockers to preservative-free ones. No significant difference was found in blood pressure and heart rate. However, a statistically significant difference was found for abnormal fluorescein staining of the cornea and conjunctiva, eyelid erythema, conjunctival hyperemia, and follicular hyperplasia. A significant difference was found for break-up time (from 9.38±4.7 s at baseline to 10.64±4.7 s after 3 months) and Schirmer's test (from 12.9±5.96 mm at baseline to 14.2±5.87 mm after 3 months). The questionnaire showed that the patient improved the dryness and foreign body sensation.


CONCLUSIONS
In glaucomatous patients, preservative-free 0.1 timolol treatment improved their QoL. Similar dry eye signs or symptoms improved after 3 months of treatment reducing dryness, hyperemia, follicular hyperplasia, and foreign body sensation.
1 Laboratorio Clinico Anatomo-Funzionale per la Diagnosi e il Trattamento del Glaucoma e Della Malattie Neurooftalmologiche, Clinica Oculistica, DiNOGMI, University of Genoa , Genoa, Italy .
Michele
M
Iester
Serena
S
Telani
Paolo
P
Frezzotti
Ilaria
I
Motolese
Michele
M
Figus
Paolo
P
Fogagnolo
Andrea
A
Perdicchi
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use; D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D015352:Dry Eye Syndromes / Q000188:drug therapy / Q000209:etiology; D005902:Glaucoma, Open-Angle / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D008137:Longitudinal Studies; D008875:Middle Aged; D009883:Ophthalmic Solutions; D011310:Preservatives, Pharmaceutical / Q000737:chemistry*; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013999:Timolol / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use
D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents; D009883:Ophthalmic Solutions; D011310:Preservatives, Pharmaceutical; D013999:Timolol