Multiparametric comparison of ocular surface properties in glaucoma patients using autologous serum or artificial tears due to ocular surface toxicity

Purpose: It was aimed to multiparametrically compare the treatment effectiveness of ocular surface toxicity caused by topical antiglaucomatous use by treating it with autologous serum and preservative-free artificial tears. Materials and Methods: This prospectively planned cancer was included in 31 eyes of 31 patients who were followed up in the Department of Ophthalmology, Balıkesir University Faculty of Medicine, using topical antiglaucomatous agents to eliminate the harmful effects on the ocular surfaces. In all patients scheduled for ocular surface disease, topical treatments were discontinued and oral antiglaucomatous treatment was started. The patients were randomly divided into two groups and either artificial pain or autologous serum was used for one month. Demographic data, best-corrected visual acuity (BCVA), intraocular pressure, duration of antiglaucomatous use, lifespan, expenditure recorded by biomicroscopic examination and burst refraction time (BUT), ocular surface staining were recorded at the first admission and after one month of treatment. Cutting of the ocular surface such as score (OXFORD), Schirmer test, corneal images (Cochet Bonnet Estesiometry), ocular surface disease index (OSDI) scoring, meibography degree and area, presence of Matrix Metalloproteinase-9 (MMP-9) in the conjunctiva. Data analysis was performed using the IBM SPSS 23.0 package program, and results were considered significant for p<0.05. Results: The mean age in the group of 15 people treated with artificial tears was 62.4±6.1 years, and the mean age in the group of 16 people treated with autologous serum was 63.8±11.2 years. There was no statistically significant difference between the treatment groups in terms of BCVA (p = 0.534), IOP (p = 0.798), corrected IOP (p = 0.810), and duration of antiglaucomatous use (p = 0.176). Although there was improvement in symptoms in both groups, the superiority of autologous serum over artificial tears was demonstrated in burning (p = 0.043) and stinging (p = 0.039) symptoms. Although all findings improved in both treatment groups, autologous serum was more effective than artificial tears in terms of conjunctival hyperemia (p = 0.044), chemosis (p = 0.025), conjunctival adhesion (p = 0.027), corneal vascularization-limbal insufficiency (p = 0.027). shown. In the group treated with artificial tears, an improvement was found in the parameters of BUT (p= 0.005), OXFORD(p=0.006), and OSDI(p=0.004). In the group treated with autologous serum, an improvement was detected in the parameters of BUT(p = 0.001), OXFORD (p=0.003),OSDI (p = 0.001) and corneal sensitivity (p = 0.016). As a result of one-month treatment, autologous serum was statistically superior to artificial tears in terms of OXFORD (p = 0.042), OSDI(p = 0.061) and corneal sensitivity (p = 0.029). The superiority of the treatment groups was not found to be significant in terms of Schirmer test, BUT, conjunctival MMP-9 positivity percentage, meibography loss degree and loss area ratio. Conclusion: While autologous serum treatment has an improvement in corneal sensitivity, an inflammation-reducing effect and a symptom-reducing effect in patients with ocular surface problems due to antiglaucomatous toxicity, its healing effect on chronic findings in short-term treatment and its superiority over artificial tears on inflammation have not been demonstrated.