Abstract
PurposeThis study aimed to determine if rebamipide eyedrops can improve ocular surface damage caused by the use of glaucoma eyedrops.MethodsFemale Kbl:Dutch rabbits were used to evaluate glaucoma eyedrop-induced ocular surface damage; one eye of each rabbit was untreated and the other was administered glaucoma eyedrops for 30 days. To evaluate the effects of rebamipide on ocular surface damage, one eye of each rabbit was administered vehicle-treated glaucoma eyedrops and the other was administered rebamipide-treated glaucoma eyedrops for 30 days. Corneal and conjunctival epithelial damage was evaluated using fluorescein and rose bengal staining, respectively. Conjunctival inflammation was observed by light microscopy with hematoxylin-eosin staining. Dark cells (in which the corneal microvilli were damaged) were analyzed by scanning electron microscopy.ResultsThere were no significant differences in fluorescein staining between the untreated and glaucoma eyedrop-treated groups; however, rose bengal staining and the number of inflammatory cells in the conjunctiva significantly increased after glaucoma eyedrop treatment. There was a four-fold increase in the number of dark cells in the glaucoma eyedrop-treated group compared to untreated. In contrast, in the conjunctiva of the rebamipide-treated glaucoma eyedrop group, rose bengal staining scores, the number of inflammatory cells, and the number of dark cells were decreased compared to the vehicle-treated glaucoma eyedrop group.ConclusionsResults from our in vivo rabbit study demonstrated that short-term use of glaucoma eyedrops induces corneal epithelium disorders at the cellular level, but that simultaneous use of rebamipide has the potential to protect and repair the ocular surface.
Highlights
Glaucoma eyedrops are the first treatment of choice to control intraocular pressure (IOP) in patients suffering from glaucoma
There were no significant differences in fluorescein staining between the untreated and glaucoma eyedrop-treated groups; rose bengal staining and the number of inflammatory cells in the conjunctiva significantly increased after glaucoma eyedrop treatment
In the conjunctiva of the rebamipide-treated glaucoma eyedrop group, rose bengal staining scores, the number of inflammatory cells, and the number of dark cells were decreased compared to the vehicle-treated glaucoma eyedrop group
Summary
Glaucoma eyedrops are the first treatment of choice to control intraocular pressure (IOP) in patients suffering from glaucoma. The main cause of these ocular surface disorders in patients with glaucoma has been reported to be the preservative benzalkonium chloride (BAK) [10,11,12], which is commonly used as a preservative in glaucoma eyedrops. When these symptoms occur, ideally, the use of eyedrops should be stopped; glaucoma patients may suffer a worsening of visual field defects caused by elevated IOP. It is necessary to identify methods that can prevent or improve ocular surface damage while continuing treatment with glaucoma eyedrops
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