[Approaches for improvement of ocular surface condition in primary open-angle glaucoma]

Area of Science:

• Ophthalmology
• Glaucoma Research
• Ocular Surface Disease

Background:

• Patients with primary open-angle glaucoma (POAG) often experience dry eye syndrome (DES) and meibomian gland dysfunction (MGD).
• Benzalkonium chloride (BAC) in fixed-combination dorzolamide-timolol (FC-DT) may exacerbate ocular surface issues.
• Effective management of POAG with co-existing DES and MGD requires careful consideration of treatment strategies.

Purpose of the Study:

• To compare the efficacy of two treatment approaches for improving ocular surface condition in POAG patients with DES and MGD.
• To evaluate the impact of preservative-free eye drops combined with eyelid hygiene versus preservative-free eye drops alone.

Main Methods:

• A randomized study involving 48 patients with stage II POAG, DES, and MGD on BAC-containing FC-DT.
• Group 1 received BAC-free FC-DT plus a specific eyelid hygiene regimen.
• Group 2 received only BAC-free FC-DT. Ocular surface parameters were assessed at baseline and after 4 weeks.

Main Results:

• Group 1 demonstrated significant improvements in OSDI score, tear break-up time (TBUT), xerosis index (XI), and MGD severity.
• Group 2 showed improvements in OSDI and TBUT, but these were less pronounced than in Group 1.
• Intraocular pressure (IOP) remained stable in both groups, indicating no significant changes.

Conclusions:

• Switching to BAC-free eye drops combined with a comprehensive eyelid hygiene regimen is more effective for improving ocular surface conditions in POAG patients with DES and MGD.
• This combined approach offers superior benefits compared to using BAC-free eye drops without adjunct eyelid care.
• The findings highlight the importance of addressing MGD and utilizing preservative-free formulations in managing complex ocular surface disease in glaucoma patients.