Effect of first-line topical medications for the treatment of glaucoma on the ocular surface in a Latin American population

BACKGROUND: First-line drug treatment is the cornerstone of glaucoma management. However, their adverse effects on the ocular surface have led to multiple retrospective studies in previously treated patients. This study evaluated these effects in patients who had never been exposed to these drugs. PURPOSE: To evaluate the effect of first-line drugs for the management of primary open-angle glaucoma and ocular hypertension on the cornea over one year of follow-up. METHODS: An observational, longitudinal, and prospective study of patients from the Colombian Caribbean coast with no prior treatment or ocular alterations. The patients were evaluated with the OCT-Cirrus 6000, the Ocular Surface Analyzer (OSA), and the OSDI survey at one-year follow-up. The statistical analysis was performed using the Epi Info v.7.2 software. RESULTS: A total of 88 eyes of 44 patients with an average age of 62.9 years were analyzed. Total corneal thickness (TCT) decreased from 537.6 to 533.8 µm, with no statistical significance, and total epithelial thickness (TET) decreased from 45.6 to 43.9 µm, a statistically significant difference. The OSDI survey increased from 7.3 to 13.4. The OSA showed a reduction in BUT from 8.3 to 6.9 s, the lipid layer from 3.8 to 3.0 nm, the tear meniscus height from 0.37 to 0.29 mm, and meibomian gland loss increased 12.6% at 1-year follow-up; all of these parameters were statistically significant. CONCLUSIONS: The findings reveal that antiglaucoma medications induce alterations in the ocular surface and cornea, and suggest that the greater the involvement of the corneal epithelium, the greater the symptoms reported by the patient.