COMPREHENSIVE EVALUATION OF MEIBOMIAN GLAND FUNCTION IN NEW VERSUS LONG TERM USERS OF TOPICAL ANTI-GLAUCOMA MEDICATIONS USING MEIBUM EXPRESSION AND TEAR FILM ANALYSIS

Abstract

Background: The prolonged use of topical anti-glaucoma medications (AGM) can have negative impacts on the meibomian glands and the stability of tear-film, so it is important to compare meibum expression and tear-film parameters between new and long-term AGM users.

Objective: To comprehensively evaluate and compare meibomian gland function and tear film parameters in new versus long-term users of topical anti-glaucoma medications.

Method: A comparative cross sectional study was conducted in Sighton Optix Eye care centre, Lahore. Participants were sampled using non-probability consecutive sampling and divided into 2 groups based on the length of time they had been using topical anti-glaucoma medication: new users with ≤6 month of topical anti-glaucoma medication use and long-term users with ≥2 year of topical anti-glaucoma medication use. Tear break-up time (TBUT) was used to assess tear-film stability and the Schirmer I test (without topical anesthesia) was used to assess tear production. The data that were collected were coded for confidentiality and analysed using the IBM SPSS Statistics version 27.0. P value < 0.05 was taken as statistically significant.

Result: Among the 60 participants, the mean age was 60.63 ± 12.06 years, with females comprising 35 (58.3%) and males 25 (41.7%). Most participants had good adherence to treatment (49, 81.7%) and primary open-angle glaucoma was the most common diagnosis (38, 63.3%). The prevalence of MGD was high in both eyes with 44 (73.3%) participants showing MGD in right eye and 48 (80.0%) in left eye. The mean quality of meibum was 1.38 ± 0.42 vs. 0.88 ± 0.31, upper lid gland loss was 23.93 ± 3.98% vs. 11.93 ± 5.84%, lower lid gland loss was 26.22 ± 4.95% vs. 11.85 ± 4.50%, OSDI score was 28.41 ± 8.91 vs. 18.90 ± 8.63, and TBUT was 7.68 ± 1.34 vs. 10.46 ± 1.24 seconds in long-term versus new users, respectively (all p<0.001). Long-term therapy was also significantly associated with the presence of MGD in both the right eye (χ²=21.82, p<0.001) and left eye (χ²=10.42, p<0.001).

Conclusion: The results showed that the prevalence of MGD was very high among patients treated with topical anti-glaucoma drugs, and that the degree of ocular surface dysfunction was higher among long-term anti-glaucoma users than among new users