Factors Predetermining Increased Aqueous Humour Flare in Long-Term Glaucoma Treatment.

G Pakuliene,I Januleviciene,L Kuzmiene

doi:10.1155/2020/7345687

G Pakuliene, I Januleviciene + Show 1 more

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https://doi.org/10.1155/2020/7345687

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Abstract

Glaucoma patients often require long-term or even lifelong medical antiglaucomatous treatment. Benzalkonium chloride (BAK) is the most frequently used preservative in medical glaucoma treatment. Laser flare photometry is the noninvasive quantitative measurement of anterior chamber protein level and helps tracking intraocular inflammation. The purpose of our study was to evaluate the ocular aqueous humour flare in glaucoma patients, scheduled for cataract surgery without any other ocular diseases, and the association with pseudoexfoliation (PEX) syndrome, number of medications used, and BAK. A prospective case-control age- and gender-matched study, including open-angle glaucoma patients (>2 years of treatment) with cataract, matched with cataract patients with no other ocular pathology (control group). We found that the aqueous humour flare was higher in the glaucoma group than in the control group. PEX syndrome increased the aqueous humour flare independently from glaucoma diagnosis. The number of used antiglaucomatous medications correlated moderately with the aqueous humour flare. The BAK index showed weak positive correlation with aqueous humour flare. A variety of factors can affect aqueous humour flare increase, including PEX syndrome, medical substance used to treat glaucoma, number of different medications, and presence of BAK. The combination of these factors is of key importance to long-term glaucoma treatment.

Highlights

Glaucoma patients often require long-term or even lifelong medical antiglaucomatous treatment [1]
Benzalkonium chloride (BAK) is the most frequently used preservative in medical glaucoma treatment [4]. e inflammatory properties of BAK are very well presented by the contribution to dry eye disease and a variety of inflammatory cytokines found on ocular surface [5, 6]
Aqueous Humour Flare. e aqueous humour flare mean (SEM) in the glaucoma group was 18.9 (2.2) pc/ms and median 17.3 pc/ms, and 10.0 (0.76) pc/ms and median was 9.2 pc/ms in the control group (p < 0.001, Mann–Whitney U test) (Figure 1). ere was no significant correlation between intraocular pressure (IOP) and aqueous humour flare (p > 0.05, Spearman’s rho)

Summary

Introduction

Glaucoma patients often require long-term or even lifelong medical antiglaucomatous treatment [1]. The developing technology allowed to identify subtle differences in aqueous humour flare increase between different glaucoma patients, different medications, or with preservative presence in medications [13,14,15,16]. E purpose of our study was to evaluate ocular aqueous humour flare in glaucoma patients, scheduled for cataract surgery without any other ocular diseases, and the association with pseudoexfoliation (PEX) syndrome, number of medications used, and BAK.

Results

Conclusion