Periorbital effects of antiglaucoma eye drops: A comparative analysis of prostaglandin analogs and other agents

Aim: Prostaglandin analogs (PGAs), which are widely used in the treatment of glaucoma, may lead to periorbital changes collectively referred to as prostaglandin-associated periorbitopathy syndrome (PAPS).This study aims to compare the effects of different antiglaucoma eye drops and their durations of use on the periorbital region.Materials and Methods: In this cross-sectional clinical study, patients diagnosed with glaucoma who were using antiglaucoma eye drops were evaluated.The patients were divided into three groups: those using PGAs (Group 1), those using non-PGA medications (Group 2), and those not using any medication (Group 3).Periorbital measurements, including margin reflex distance 1 (MRD1), levator function (LF), inferior scleral show, deepening of the upper eyelid sulcus (DUES), malar edema, and lower eyelid fat herniation, were assessed.Results: MRD1 was significantly lower in Group 1 than in the other groups (p = 0.0001).LF was lowest in Group 1, higher in Group 2, and highest in Group 3 (p = 0.0001).DUES was most prominent in Group 1, less pronounced in Group 2, and least observed in Group 3 (p = 0.0001).As the duration of medication use increased, a decrease in MRD1 and LF was observed in both Group 1 (p = 0.0001 and p = 0.0001, respectively) and Group 2 (p = 0.001 and p = 0.0001, respectively).While DUES became more prominent with increased medication duration in Group 1 (p = 0.007).Discussion: PGAs were associated with a decrease in MRD1 and LF values, leading to ptosis and DUES.Other antiglaucoma eye drops did not cause significant ptosis but were linked to certain periorbital changes.