Changes in ocular surface after withdrawal of anti-glaucoma medications following non-penetrating deep sclerectomy

ABSTRACT

Purpose: To analyze the ocular surface changes in eyes after the withdrawal of anti?glaucomatous drugs when non?penetrating deep sclerectomy (NPDS) is performed. Methods: Thirty?one patients (33 eyes) diagnosed with glaucoma that underwent NPDS were included in this prospective study. The control group included 33 eyes. Four variables were studied using Keratograph 5M (K5M) ocular hyperemia (OH), non?invasive tear film break?up time (NI?BUT), lower tear meniscus height (LTMH), and meibography. LTMH was also measured using the anterior segment module of a Spectralis Fourier?domain optical coherence tomography (FD?OCT) instrument. Moreover, an evaluation of corneal and conjunctival staining was performed. In the glaucoma group, five visits were carried out pre?surgery, 1 week after surgery, and 1 month, 3 months, and 6 months after surgery. In control groups, examinations were performed in only one visit. In addition, patients were asked to answer two questionnaires Ocular Surface Disease Index (OSDI) and National Eye Institute Visual Functioning Questionnaire (NEI VFQ?25) before and 6 months after surgery. Results: Before NPDS, eyes showed worse objective data than healthy control subjects (P ? 0.049). In this group, a significant improvement was observed in questionnaire responses (P < 0.001), LTMH?FD?OCT (P = 0.037), LTMH?K5M (P = 0.025), K5M?OH (P = 0.003), NI?BUT (P = 0.022), and conjunctival and corneal staining (P < 0.001). No significant differences were observed between groups in FD?OCT and K5M LTMH, NI?BUT, corneal?conjunctival staining, nor in the most OH sector values at 6 months (P ? 0.62). Conclusion: A significant improvement in the ocular surface was observed 6 months after NPDS, suggesting that the withdrawal of the topical anti?glaucomatous treatment had a beneficial effect on the subjects: