Abstract
Purpose. To examine the efficacy of ophthalmic rebamipide suspensions on ocular surface disorders induced by antiglaucoma eye drops. Patients and Methods. Forty eyes of 40 patients receiving latanoprost (0.005%) and timolol (0.5%) were included in this randomized prospective study. The patients were randomly divided into two groups (n = 20): the rebamipide-treated group and control group. Changes in intraocular pressure, tear film break-up time (TBUT), and corneal epithelial barrier function were evaluated at baseline, 4 weeks, and 8 weeks after rebamipide administration. Furthermore, superficial punctate keratopathy severity was evaluated by scoring the lesion area and density. Results. There was no significant difference in intraocular pressure before and after rebamipide treatment. However, corneal epithelial barrier function improved significantly 4 and 8 weeks after rebamipide treatment. TBUT was partially, but significantly, increased (P = 0.02) 8 weeks after rebamipide treatment, whereas no significant change was observed at 4 weeks. Additionally, a significant decrease in area and density of keratopathy was observed 8 weeks after rebamipide treatment but not at 4 weeks. The control group showed no significant difference compared to baseline. Conclusions. Our data suggests that rebamipide treatment may reduce the occurrence of drug-induced ocular surface disorder.
Highlights
Ocular surface diseases occur in 15% of elderly patients and 48–59% of patients with glaucoma [1,2,3]
Rebamipide treatment had no effect on the intraocular pressure in patients receiving antiglaucoma eye drops (16.6 ± 2.3 mmHg at baseline; 15.8 ± 2.3 mmHg after 4 weeks; and 15.6 ± 1.8 mmHg after 8 weeks)
Substantial increases in fluorescein uptake were observed in both groups at baseline, since both groups received 0.005% latanoprost containing benzalkonium chloride (BAK) and 0.5% timolol containing BAK, indicating the existence of corneal epithelial barrier dysfunction induced by antiglaucoma drops
Summary
Ocular surface diseases occur in 15% of elderly patients and 48–59% of patients with glaucoma [1,2,3]. Ocular surface disease is hypothesized to occur in patients with glaucoma due to the side effects of antiglaucoma eye drops or glaucoma surgery. Because of its effects on gastric mucin secretion, it was hypothesized that rebamipide might enhance mucin production in conjunctival goblet cells. Previous studies indicate that mucin production in conjunctival goblet cells was increased after rebamipide treatment [8, 9]. A recent study demonstrated that rebamipide ophthalmic suspensions were effective in treating keratoconjunctivitis sicca in patients with Sjogren’s syndrome [11], its effect on the ocular surface condition in glaucoma patients who are using antiglaucoma eye drops remains unclear
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