title: Vitamin A Palmitate and Carbomer Gel Protects the Conjunctiva of Patients With Long-term Prostaglandin Analogs Application.
abstract: To investigate the protective effects of vitamin A palmitate and carbomer gel on the morphology of conjunctival epithelium and density of goblet cells (GCs) in patients on long-term prostaglandin analogs (PGAs) application.
  
  
  
  In this prospective cohort study, 23 primary open-angle glaucoma patients and 7 normal-tension glaucoma patients prescribed PGAs for >1 year were enrolled into 3 identical clinical trials and randomized into 3 groups (10 per group). Patients were treated twice daily with vitamin A palmitate eye gel 0.1%, or carbomer eye gel 0.2%, or no additional application of these 2 drugs. Ocular surface disease index questionnaires, Schirmer 1 test without anesthesia, tear break-up time test, and GCs density assessment by in vivo confocal microscopy and conjunctival impression cytology analysis were performed at baseline and at months 1, 3, and 6 of the study.
  
  
  
  Both vitamin A palmitate and carbomer gel led to a significant improvement in ocular surface disease index questionnaires score and prevented the gradual decline in tear break-up time. Vitamin A palmitate significantly increased the GC density after treatment. The GC density assessed by in vivo confocal microscopy positively correlated with that measured by conjunctival impression cytology.
  
  
  
  Vitamin A palmitate and carbomer eye gel can effectively relieve dry eye symptom caused by long-term application of PGAs by increasing the GCs density and thereby reducing the toxicity to the conjunctiva. Vitamin A palmitate and carbomer eye gel may be valuable alternatives for glaucoma patients who prescribed long-term PGAs.
authors: *Ophthalmology Department, Eye and ENT Hospital of Fudan University †Ophthalmology Department, Jinshan Hospital of Fudan University, Shanghai, China.
authors: Xinhan
authors: X
authors: Cui
authors: Jun
authors: J
authors: Xiang
authors: Wenqing
authors: W
authors: Zhu
authors: Anji
authors: A
authors: Wei
authors: Qihua
authors: Q
authors: Le
authors: Jianjiang
authors: J
authors: Xu
authors: Xiaodong
authors: X
authors: Zhou
mesh_terms: D000180:Acrylic Resins / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000009:adverse effects; D000975:Antioxidants / Q000008:administration & dosage / Q000627:therapeutic use; D015331:Cohort Studies; D003228:Conjunctiva / Q000166:cytology / Q000187:drug effects*; D004224:Diterpenes; D004311:Double-Blind Method; D015352:Dry Eye Syndromes / Q000139:chemically induced / Q000503:physiopathology / Q000517:prevention & control*; D004848:Epithelium / Q000187:drug effects; D005260:Female; D005902:Glaucoma, Open-Angle / Q000188:drug therapy*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D057066:Low Tension Glaucoma / Q000188:drug therapy*; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000008:administration & dosage / Q000627:therapeutic use; D011446:Prospective Studies; D011461:Prostaglandins F, Synthetic / Q000009:adverse effects*; D000084562:Retinyl Esters; D011795:Surveys and Questionnaires; D013666:Tears / Q000502:physiology; D014801:Vitamin A / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000180:Acrylic Resins; D000959:Antihypertensive Agents; D000975:Antioxidants; D004224:Diterpenes; D009883:Ophthalmic Solutions; D011461:Prostaglandins F, Synthetic; D000084562:Retinyl Esters; D014801:Vitamin A; C014794:retinol palmitate; C006903:carbopol 940