Tear replacement by cationic emulsion in complex therapy of superficial punctate keratitis in hypotensively medicated glaucoma patients

• Main Authors: S. V. Trufanov, S. A. Malozhen, D. A. Krakhmaleva, E. A. Pivin
• Format: Article
• Language: Russian
• Published: Real Time Ltd 2018-10-01
• Series: Российский офтальмологический журнал
• Subjects: поверхностный точечный кератит; синдром «сухого глаза»; глаукома; консерванты; тест ширмера; проба норна; осмолярометрия; кератопротекторы; слезозаместительная терапия; катионорм; superficial punctate keratitis; dry eye syndrome; glaucoma; preservatives; schirmer test; norn test; tear film osmolarity; cationorm
• Online Access: https://roj.igb.ru/jour/article/view/59
• ISSN: 2072-0076; 2587-5760

Purpose. To evaluate the efficacy of lubricating cationic emulsion in the combined treatment of superficial punctate keratitis (SPK) of glaucoma patients. Material and methods. The clinical study involved an experimental group 1 of 28 patients (30 eyes) aged 50 to 84 (mean age 67.1 ± 7.2 years) with symptoms of SPK who received long-term (averagely 9.5 ± 6.6 years) topical hypotensive anti-glaucoma medication. The control group 2 consisted of 26 patients (mean age 67.6 ± 7.1 years) belonging to the experimental group: in this case, the contralateral eyes with topical anti glaucoma medication but no signs of keratitis were examined. The basic therapy for group 1 consisted of topical antihistamine, corneoprotector (dexpanthenol) and a new generation lubricant, Cationorm. Group 2 was also treated with Cationorm. The testing procedures and efficiency monitoring included biomicroscopy, Schirmer test, Norn test and evaluation of tear film osmolarity. Results. Dry eye symptoms with disturbed tear film osmolarity and decreased values of Norn and Schirmer tests were detected in all patients both in the eyes with SPK manifestations and without them. Patients with concomitant dry eye syndrome who received complex therapy, including Cationorm, showed increased tear film stability: Norn sample values increased from 5.5 ± 1.8 to 8.5 ± 2.1 seconds and from 7.7 ± 1.4 to 8.8 ± 2.2 seconds in groups 1 and 2, respectively, p < 0.05). Besides, the values of the Schirmer test improved from 6.3 ± 2.1 to 8.3 ± 3.7 mm and 8.7 ± 3.7 to 9.1 ± 3.8 mm in groups 1 and 2, respectively, p < 0.05), and osmolarityrate decreased in both groups, p < 0.05. Subjective symptoms in group 1 changed from 3.4 to 0.6 points after 3 months of treatment. The average severity of SPK, which amounted to 4.2 ± 2.3 points before treatment, dropped to 1.2 ± 0.9, 0.23 ± 0.5 and 0.1 ± 0.3 points respectively after 1, 2 and 3 months. Conclusion. The study shows that Cationorm can be considered as a tear replacement lubricant of choice in the complex therapy of superficial punctate keratitis and dry eye symptoms in chronically medicated glaucoma patients // Russian Ophthalmological Journal, 2016; 4: 52-7. doi: 10.21516/2072-0076-2016-9-4-52-57.