The effect of preservative-free treatment of primary open-angle glaucoma on the state of ocular surface in combination therapy (intermediate results)

Abstract

To assess the state of ocular surface in patients with POAG when switching to preservative-free carbonic anhydrase inhibitor (ICA) containing 0.18% sodium hyaluronate in combination with prostaglandin analogues and beta-adrenergic blocking agents. The study was conducted in 2019; according to selection criteria, it included 46 patients (80 eyes) with POAG and a control group of healthy persons. At the start of the study and one month later, after a change of treatment to uninterrupted ICA containing 0.18% sodium hyaluronate, the patients had state of their ocular surface examined: Norn's test (tear break-up time; TBUT), Schirmer's test, vital staining with lissamine green and an Ocular Surface Disease Index (OSDI) survey. Replacing the ICA with benzalkonium chloride in the combination therapy of glaucoma with a preservative-free ICA containing 0.18% sodium hyaluronate - Dorzolan Solo (Solopharm, Russia) - expectedly did not lead to additional decrease of IOP, but resulted in a decrease in the width of the confidence interval according to both Maklakov's and Icare tonometers, which may be associated with increased treatment adherence. At the same time, the state of ocular surface in the observation group was statistically significantly improved according to Norn's test - from 3.57±1.3; 3.0 (3.0; 5.0) to 4.9±2.5; 5.0 (3.0; 6.0) (V=16.5; p=0.0039). According to Schirmer's test and vital staining with lissamine green, no statistically significant changes have occurred. OSDI survey did not reveal changes in the study patients during 4 weeks of the follow-up, while the control group exhibited improvement.