Terai Naim, Müller-Holz Matthias, Spoerl Eberhard, Pillunat Lutz E
Department of Ophthalmology, Carl Gustav Carus University Hospital, Dresden, Germany.
Clin Ophthalmol. 2011;5:517-25. doi: 10.2147/OPTH.S18849. Epub 2011 Apr 26.
The purpose of this study was to investigate the short-term effect of topical antiglaucoma medication on tear-film stability, tear secretion, and corneal sensitivity in healthy subjects.
In this prospective, double-blind crossover trial, break-up time and basal secretion (Jones test) were measured 60 minutes before, and 30, 60, and 90 minutes after topical antiglaucoma drop application in 30 healthy subjects. Corneal sensitivity was measured 60 minutes before, and five, 10, and 15 minutes after drop application using a Cochet-Bonnet esthesiometer.
Reduction of break-up time in the latanoprost group was -23.8% after 30 minutes (P = 0.21), -26.7% after 60 minutes (P = 0.03) and -51.4% after 90 minutes (P ≤ 0.003), which was statistically significant. Reduction of break-up time in all other treatment groups was not statistically significant. The Jones test revealed a significant reduction of basal secretion after application of brimonidine (-17.8%, P = 0.002; -22.5%, P < 0.001; -30.5%, P < 0.001), followed by apraclonidine (-10%, P = 0.06; -20.1%, P = 0.02; -22.1%, P = 0.002), latanoprost (-2.4%, P = 0.64; -18.6%, P = 0.001; -20.1%, P = 0.001) and dorzolamide (-0.5%, P = 0.9; 14.3%, P = 0.018; -17.3%, P = 0.004) at 30, 60, and 90 minutes after drop application. Reduction of basal secretion in all other treatment groups was not statistically significant.
Latanoprost showed the most statistically significant reduction in break-up time, and brimonidine showed the most significant reduction in basal secretion of all the glaucoma medications used in this study. In conclusion, our data may be helpful for treatment decisions in glaucoma patients who also suffer from ocular surface problems.
本研究旨在调查局部抗青光眼药物对健康受试者泪膜稳定性、泪液分泌及角膜敏感性的短期影响。
在这项前瞻性、双盲交叉试验中,对30名健康受试者在局部应用抗青光眼滴眼液前60分钟,以及应用后30、60和90分钟测量泪膜破裂时间和基础分泌量(琼斯试验)。使用Cochet-Bonnet角膜知觉计在应用滴眼液前60分钟,以及应用后5、10和15分钟测量角膜敏感性。
拉坦前列素组在应用30分钟后泪膜破裂时间减少-23.8%(P = 0.21),60分钟后减少-26.7%(P = 0.03),90分钟后减少-51.4%(P≤0.003),具有统计学意义。所有其他治疗组泪膜破裂时间的减少无统计学意义。琼斯试验显示,应用溴莫尼定后基础分泌量显著减少(-17.8%,P = 0.002;-22.5%,P < 0.001;-30.5%,P < 0.001),其次是阿可乐定(-10%,P = 0.06;-20.1%,P = 0.02;-22.1%,P = 0.002)、拉坦前列素(-2.4%,P = 0.64;-18.6%,P = 0.001;-20.1%,P = 0.001)和多佐胺(-0.5%,P = 0.9;14.3%,P = 0.018;-17.3%,P = 0.004),分别在应用滴眼液后30、60和90分钟。所有其他治疗组基础分泌量的减少无统计学意义。
在本研究中使用的所有青光眼药物中,拉坦前列素在泪膜破裂时间减少方面显示出最显著的统计学差异,溴莫尼定在基础分泌量减少方面显示出最显著的差异。总之,我们的数据可能有助于患有眼表问题的青光眼患者的治疗决策。