Efficacy of tear replacement therapy in patients with iatrogenic dry eye syndrome induced by long-term use of antiglaucoma drugs

Aim. To evaluate the efficacy of a tear substitute composed of the combination of trehalose and sodium hyaluronate (Gylan® Extra) in the treatment of iatrogenic dry eye syndrome caused by the long-term use of antiglaucoma drops.

Materials and methods. A total of 35 patients (70 eyes) with glaucoma of different stages and compensated intraocular pressure while using topical antiglaucoma drugs containing benzalkonium chloride (BC) as a preservative were examined. The duration of treatment ranged from 3 months to 14 years. In addition to the hypotensive medication regimen, all patients were prescribed a tear substitute. The patients underwent medical examinations before the prescription of tear replacement therapy, as well as 1 and 6 months after initiation of therapy. The treatment efficacy was evaluated using biomicroscopy, functional tests (Norn, Schirmer’s and Jones tests), and laser confocal microscopy.

Results and discussion. Among patients receiving the hypotensive therapy combined with tear replacement therapy containing trehalose and sodium hyaluronate, 89% showed an improvement in their corneal epithelium condition, a reliable increase in average precorneal tear film breakup time (TBUT): at 1 month – more than 1.5 times, at 6 months – 2 times (p < 0.001). The indicators of total and basic tear secretion increased by 3.4% and 16.6% (p = 0.039) and by 7.8% and 18.3% (p = 0.068), respectively.

Conclusion. The results of the study show the efficacy and appropriateness of prescribing a tear substitute containing trehalose and sodium hyaluronate to treat iatrogenic dry eye syndrome that developed during the long-term use of local hypotensive drugs containing the preservative BC.

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