Ocular lubricant use in medically and surgically treated glaucoma: a retrospective longitudinal analysis

Jayant Venkatramani Iyer,1–3 Yang Zhao,3 Fiona Pin Miao Lim,1,2 Louis Tong,1–4 Tina Tzee Ling Wong1–41Glaucoma, Singapore National Eye Centre, 2Singapore Eye Research Institute, 3Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singap...

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Autores principales:	Iyer JV, Zhao Y, Lim FPM, Tong L, Wong TTL
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	glaucoma medications trabeculectomy ocular surface disease ocular lubricants Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/c2fa5877a16e4ad8938ce4734ef68a79
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spelling	oai:doaj.org-article:c2fa5877a16e4ad8938ce4734ef68a792021-12-02T01:19:50ZOcular lubricant use in medically and surgically treated glaucoma: a retrospective longitudinal analysis1177-5483https://doaj.org/article/c2fa5877a16e4ad8938ce4734ef68a792017-06-01T00:00:00Zhttps://www.dovepress.com/ocular-lubricant-use-in-medically-and-surgically-treated-glaucoma-a-re-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Jayant Venkatramani Iyer,1–3 Yang Zhao,3 Fiona Pin Miao Lim,1,2 Louis Tong,1–4 Tina Tzee Ling Wong1–41Glaucoma, Singapore National Eye Centre, 2Singapore Eye Research Institute, 3Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, 4Ophthalmology Academic Clinical Program, Duke-NUS Graduate Medical School, SingaporeBackground: Chronic use of intraocular pressure-lowering medications is associated with ocular surface disease (OSD). In this study, we assess the incidence of topical lubricant use as a surrogate marker for underlying OSD, in medically and surgically treated glaucoma patients.Methods: Retrospective chart review was performed for newly diagnosed glaucoma patients who were started on topical medications in 2007 and followed up over a 5-year period. Primary outcome measure was the incidence of topical lubricant use in these patients and a subset of these patients who required glaucoma or cataract surgery during follow-up.Results: Charts of 505 newly diagnosed glaucoma patients with no prior history of ocular lubricant use were analyzed. Mean age was 63.9 years (SD 11.1), 42.8% were women. One hundred one (20.0%) patients underwent phacoemulsification surgery, 80 underwent mitomycin C (MMC) augmented phacotrabeculectomy, 16 underwent MMC-augmented trabeculectomy and 3 underwent tube surgery during the course of follow-up as their only type of surgery. Five-year incidence of lubricant use was 59% in all glaucoma subjects; 54.1% of patients were on medical treatment and 74.0% of patients who underwent phacotrabeculectomy or trabeculectomy were started on lubricants, respectively (P=0.0011); 60.4% of glaucoma subjects who underwent phacoemulsification surgery were started on lubricants. Incidence of lubricant use increased from 17.7% preoperatively to 74.0% postoperatively in subjects who required trabeculectomy or phacotrabeculectomy. Incidence of lubricant use was similar in patients on one or multiple glaucoma medications, with the mean onset of lubricant use being 10 months after starting glaucoma medication in both groups. Females were more likely to use artificial tears compared with males (P=0.002).Conclusion: Both medical and surgical management of glaucoma have an adverse effect on the ocular surface. Chronic use of glaucoma medications was associated with a high incidence of ocular lubricant use. MMC-augmented trabeculectomy was associated with an even higher incidence of ocular lubricant use.Keywords: glaucoma, medications, trabeculectomy, ocular surface disease, ocular lubricantsIyer JVZhao YLim FPMTong LWong TTLDove Medical Pressarticleglaucomamedicationstrabeculectomyocular surface diseaseocular lubricantsOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 11, Pp 1191-1196 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	glaucoma medications trabeculectomy ocular surface disease ocular lubricants Ophthalmology RE1-994
spellingShingle	glaucoma medications trabeculectomy ocular surface disease ocular lubricants Ophthalmology RE1-994 Iyer JV Zhao Y Lim FPM Tong L Wong TTL Ocular lubricant use in medically and surgically treated glaucoma: a retrospective longitudinal analysis
description	Jayant Venkatramani Iyer,1–3 Yang Zhao,3 Fiona Pin Miao Lim,1,2 Louis Tong,1–4 Tina Tzee Ling Wong1–41Glaucoma, Singapore National Eye Centre, 2Singapore Eye Research Institute, 3Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, 4Ophthalmology Academic Clinical Program, Duke-NUS Graduate Medical School, SingaporeBackground: Chronic use of intraocular pressure-lowering medications is associated with ocular surface disease (OSD). In this study, we assess the incidence of topical lubricant use as a surrogate marker for underlying OSD, in medically and surgically treated glaucoma patients.Methods: Retrospective chart review was performed for newly diagnosed glaucoma patients who were started on topical medications in 2007 and followed up over a 5-year period. Primary outcome measure was the incidence of topical lubricant use in these patients and a subset of these patients who required glaucoma or cataract surgery during follow-up.Results: Charts of 505 newly diagnosed glaucoma patients with no prior history of ocular lubricant use were analyzed. Mean age was 63.9 years (SD 11.1), 42.8% were women. One hundred one (20.0%) patients underwent phacoemulsification surgery, 80 underwent mitomycin C (MMC) augmented phacotrabeculectomy, 16 underwent MMC-augmented trabeculectomy and 3 underwent tube surgery during the course of follow-up as their only type of surgery. Five-year incidence of lubricant use was 59% in all glaucoma subjects; 54.1% of patients were on medical treatment and 74.0% of patients who underwent phacotrabeculectomy or trabeculectomy were started on lubricants, respectively (P=0.0011); 60.4% of glaucoma subjects who underwent phacoemulsification surgery were started on lubricants. Incidence of lubricant use increased from 17.7% preoperatively to 74.0% postoperatively in subjects who required trabeculectomy or phacotrabeculectomy. Incidence of lubricant use was similar in patients on one or multiple glaucoma medications, with the mean onset of lubricant use being 10 months after starting glaucoma medication in both groups. Females were more likely to use artificial tears compared with males (P=0.002).Conclusion: Both medical and surgical management of glaucoma have an adverse effect on the ocular surface. Chronic use of glaucoma medications was associated with a high incidence of ocular lubricant use. MMC-augmented trabeculectomy was associated with an even higher incidence of ocular lubricant use.Keywords: glaucoma, medications, trabeculectomy, ocular surface disease, ocular lubricants
format	article
author	Iyer JV Zhao Y Lim FPM Tong L Wong TTL
author_facet	Iyer JV Zhao Y Lim FPM Tong L Wong TTL
author_sort	Iyer JV
title	Ocular lubricant use in medically and surgically treated glaucoma: a retrospective longitudinal analysis
title_short	Ocular lubricant use in medically and surgically treated glaucoma: a retrospective longitudinal analysis
title_full	Ocular lubricant use in medically and surgically treated glaucoma: a retrospective longitudinal analysis
title_fullStr	Ocular lubricant use in medically and surgically treated glaucoma: a retrospective longitudinal analysis
title_full_unstemmed	Ocular lubricant use in medically and surgically treated glaucoma: a retrospective longitudinal analysis
title_sort	ocular lubricant use in medically and surgically treated glaucoma: a retrospective longitudinal analysis
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/c2fa5877a16e4ad8938ce4734ef68a79
work_keys_str_mv	AT iyerjv ocularlubricantuseinmedicallyandsurgicallytreatedglaucomaaretrospectivelongitudinalanalysis AT zhaoy ocularlubricantuseinmedicallyandsurgicallytreatedglaucomaaretrospectivelongitudinalanalysis AT limfpm ocularlubricantuseinmedicallyandsurgicallytreatedglaucomaaretrospectivelongitudinalanalysis AT tongl ocularlubricantuseinmedicallyandsurgicallytreatedglaucomaaretrospectivelongitudinalanalysis AT wongttl ocularlubricantuseinmedicallyandsurgicallytreatedglaucomaaretrospectivelongitudinalanalysis
_version_	1718403161206554624

Ocular lubricant use in medically and surgically treated glaucoma: a retrospective longitudinal analysis

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