AIM: To detect the effects of topical antiglaucoma medication on the ocular surface structures in glaucoma patients.

METHODS: Forty-nine eyes from 35 patients treated with topical antiglaucoma medication over 3mo and 45 eyes from 45 normal subjects were collected. The antiglaucoma medication group was divided to subgroup A(single antiglaucoma medication treated group)and subgroup B(combined antiglaucoma medication treated group). The ocular surface structures were performed in all subjects, including Schirmer I test(S I t), tear film break-up time(BUT), fluorescein staining(FL), rose bengal staining(RB), conjunctival impression cytology(CIC), goblet cells density(GCD), content of tear MUC5AC.

RESULTS:The results of S I t was 11.54±5.47mm, and BUT was 11.86±3.13s, and FL and RB score was0.42±0.61 and 0.37±0.98 in normal control group, which was 8.11±4.30mm and 7.49±2.62s, and 1.15±0.87, 1.28±1.08 respectively in antiglaucoma medication group. The differences were significant between normal group and antiglaucoma medication group(t=3.395, P=0.001; t=7.363, P=0.001, t=-4.266, P=0.001; t=7.363, P=0.000); The results of S I t was 9.51±4.76mm, BUT was 8.46±1.24s, and FL and RB score was 0.91±1.03 and 0.85±1.07 in subgroup A, which was 6.34±4.05mm and 6.38±1.25s, and FL and RB score was 1.84±1.14 and 1.56±1.31 in subgroup B. The differences were significant between subgroup A and subgroup B(t=2.514, P=0.012; t=5.844, P=0.000; t=-2.992, P=0.003; t=-2.072, P=0.043). Compared with normal control group, conjunctival epithelium cells damage was observed in antiglaucoma medication group that cell volume enlarged, and cytoplasm/nucleus decreased. The score of CIC of antiglaucoma medication group was significantly increased compared with normal control group(u=6.354, P=0.000), while there was no difference between subgroup A and subgroup B(u=0.69, P=0.48). GCD of normal group and antiglaucoma medication group was(68.37±12.82)/mm² and(32.83±10.68)/mm² respectively. The difference was dramatically(t=14.610, P=0.000); GCD of subgroup A and subgroup B was(39.12±9.35)/mm² and(27.58±8.47)/mm², which was statistically different(t=4.530, P=0.001). The content of tear MUC5AC was significantly decreased in antiglaucoma medication group(13.84±6.72ng/mL)compared with normal control group(32.61±8.65ng/mL)(t=11.804, P=0.000), while the content of tear MUC5AC was also significantly decreased in subgroup B(10.67±4.58ng/mL)compared with subgroup A(20.17±5.84ng/mL)(t=6.349, P=0.000).

CONCLUSION: Topical antiglaucoma medication can decrease tear secretionand tear film stability and damage ocular surface. Combined antiglaucoma medication caused severe damage on ocular surface structures.