Tear substitute in preoperative preparation of patients with glaucoma

Background Glaucoma remains one of the leading causes of irreversible vision loss worldwide. Currently, surgical methods are the mainstay of glaucoma treatment [1, 2], but their effectiveness is reduced due to postoperative scarring. There are data in the literature linking excessive scarring with the use of drops containing preservatives and the number of such drops used by the patient [3]. Preoperative preparation with a three-component tear substitute can improve the results in patients using drugs with preservatives [4, 5]. Objective To evaluate the effect of preoperative preparation with a three-component tear substitute on the results of glaucoma surgery in patients taking antiglaucoma drugs with preservatives for a long time. Material and methods The study included 63 patients (63 eyes) with open-angle glaucoma, of which 33 patients underwent preoperative preparation using a tear substitute (Group 1), 30 patients did not use additional means (Group 2). All patients received antihypertensive therapy with drugs containing the preservative benzalkonium chloride. Participants underwent a complete ophthalmological examination before surgery and after 1 week, 1; 3 and 6 months. Results The average level of intraocular pressure (IOP) increase after 6 months in the group without preparation was significantly higher than in patients using a three-component tear substitute. After 3 months, 87.9% of patients in the group with preoperative preparation had favorable diffuse AF, while in the group without preparation this figure was 66.7%. The use of artificial tears reduced the risk of increasing IOP to 20 mm Hg and higher in the early postoperative period by more than 10 times. Conclusion Three-component artificial tears reduce the risk of postoperative IOP increase in patients taking drugs with preservatives for a long time, improve the condition of the AF and overall treatment results. Keywords: glaucoma; artificial tears; filtration pillow; optical coherence tomography; glaucoma surgery