title: The utility of an artificial substitute to improve corneal sensitivity in glaucomatous patients on chronic therapy with prostaglandin analogs.
abstract: OBJECTIVE
  To evaluate whether a tear substitute can improve corneal subepithelial nerve plexus and corneal sensitivity in glaucomatous patients.
  
  
  METHODS
  This study was prospective, longitudinal, and single arm. Twenty glaucomatous patients were recruited. All the patients were treated with a prostaglandin analog with preservative for at least 1 year. Preservative-free artificial tears (0.5% tamarind seed polysaccharide 0.5(®) eye drops single-dose preservative free [Oftagen]) were prescribed thrice per day. The participants were subjected to clinical and instrumental evaluation at baseline (T0), after 1 month (T1) and after 3 months (T3) of treatment. All patients were examined with a digital corneal confocal laser-scanning microscope (HRT II Rostock Cornea Module; Heidelberg Engineering GmbH) and Cochet-Bonnet corneal esthesiometer.
  
  
  RESULTS
  After the artificial substitute, corneal and conjunctival sensitivity significantly (P < 0.001) improved at T1 and T3 compared to the baseline. A significant correlation was found between break-up time and both central corneal sensitivity and the number of fibers.
  
  
  CONCLUSIONS
  The use of a preservative-free artificial substitute in association with a topical therapy with chronic preservative could increase the compliance of patients.
authors.affiliation: 1Clinica Oculistica, DiNOGMI, University of Genoa, Genoa, Italy.
authors.forename: Aldo
authors.initials: A
authors.lastname: Vagge
authors.affiliation: 1Clinica Oculistica, DiNOGMI, University of Genoa, Genoa, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Bonino
authors.affiliation: 1Clinica Oculistica, DiNOGMI, University of Genoa, Genoa, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Rolando
authors.affiliation: 2Azienda Ospedaliera Universitaria San Martino IST, Genova, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Macrì
authors.affiliation: 1Clinica Oculistica, DiNOGMI, University of Genoa, Genoa, Italy.
authors.forename: Carlo E
authors.initials: CE
authors.lastname: Traverso
authors.affiliation: 1Clinica Oculistica, DiNOGMI, University of Genoa, Genoa, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Iester
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000009:adverse effects; D001548:Benzalkonium Compounds / Q000008:administration & dosage / Q000009:adverse effects; D003228:Conjunctiva / Q000187:drug effects* / Q000294:innervation / Q000502:physiology; D003315:Cornea / Q000187:drug effects* / Q000294:innervation / Q000502:physiology; D005260:Female; D005901:Glaucoma / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D006801:Humans; D008137:Longitudinal Studies; D065346:Lubricant Eye Drops / Q000008:administration & dosage* / Q000493:pharmacokinetics; D008297:Male; D018613:Microscopy, Confocal / Q000379:methods; D008875:Middle Aged; D009883:Ophthalmic Solutions; D011310:Preservatives, Pharmaceutical / Q000008:administration & dosage / Q000009:adverse effects; D011446:Prospective Studies; D011465:Prostaglandins, Synthetic / Q000008:administration & dosage*
chemical_list: D000891:Anti-Infective Agents, Local; D001548:Benzalkonium Compounds; D065346:Lubricant Eye Drops; D009883:Ophthalmic Solutions; D011310:Preservatives, Pharmaceutical; D011465:Prostaglandins, Synthetic