Ocular Surface Disorder And Glaucoma Medication – A Prospective Contralateral Study

A) To study the basic ocular surface status in a glaucoma cohort on bilateral local glaucoma medication. B) To study how their ocular surface status changed when medication was reduced or eliminated in one eye after MIGS surgery in one eye compared to the non-operated control eye 

Single surgeon private eye clinic in Haugesund, Norway 

We planned to recruit 30 patients on bilateral glaucoma medication for at least 12 months. This abstract is based on an interim analysis of the first 20 subjects included.  

All study subjects underwent a thorough clinical eye examination including an in-depth examination of their Ocular Surface Status. One eye pr study subject was randomly chosen for either combined cataract and MIGS surgery or MIGS surgery alone. At the final 6 month visit the extensive preoperative OSD protocol was repeated and results compared to the preoperative status both in the intervention group (MIGS) and the control group (continued medical treatment). Advanced metobolomics tear film analyses were performed at inclusion and after the end of the study

Based on the inclusion data collection, 77% of study subjects met the criteria of significant OSD on inclusion (DEWS II). At the 6 months end visit, the MIGS intervention eyes had an incidence of OSD of 43% compared to 72% in the control group. The number of medications was reduced from 2.11 to 1.34 and the IOP reduction was reduced by 5.6 mmHg in the intervention group. Subjective questionnaire SPEED score showed a significant reduction between the two groups.  

The incidence of seriously compromised ocular surface in a glaucoma cohort was high. Surgical intervention which made it possible to reduce or stop glaucoma medication resulted in a significant improvement of their ocular surface status both objectively and subjectively. Local glaucoma treatment seems to be a significant risk factor for developing OSD.

Further details in our findings including advanced metabolomics and lipidomics analyses will be presented and discussed in depth.