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Editors Selection IGR 21-4
Medical Treatment: Preventing Ocular Surface Disease in Prostaglandin-treated Patients
Comment by Esther Hoffmann on:
77008 Effect of a punctal plug on ocular surface disease in patients using topical prostaglandin analogues: a randomized controlled trial, Sherwin JC; Ratnarajan G; Elahi B et al., Clinical and Experimental Ophthalmology, 2018; 0:
It is well known that antiglaucomatous eye drops - whether they are with or without preservatives - may influence ocular surface integrity tremendously. Many glaucoma patients complain dryness, hyperemia and foreign body sensation while using their eye drops.
Sherwin and colleagues performed a randomized clinical trial and included 60 patients under prostaglandin antiglaucomatous therapy of whom 48 participated in the trial. Punctal plugs were applied in one eye (inferior punctum), leaving the fellow eye as control. The following parameters were observed over a period of six weeks: Ocular surface disease index (OSDI- questionnaire), tear-film breakup time (TF-BUT), Oxford Cornea score, tear osmolarity and intraocular pressure were compared at baseline and six weeks by masked investigators. The results showed that the objective and subjective parameters improved over time.
A small but statistically significant influence on IOP values was measured between eyes that received punctal plugs (lower IOP ) and eyes that received no plugs (higher IOP).
Although the study had a small sample size and the effects between the two eyes were possibly not clinically significant, there is, however, an association between occlusion of punctums and better objective and subjective status of ocular surface disease.
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