Comparison of the Long-Term Effects of Various Topical Antiglaucoma Medications on Meibomian Glands

Purpose: To examine the effects of long-term antiglaucoma eye drop treatment on meibomian glands. Methods: The subjects were 71 eyes of 71 glaucoma patients (group 1) receiving one type of antiglaucoma eye drops, 61 eyes of 61 glaucoma patients (group 2) receiving two types of antiglaucoma eye drops, and 30 eyes of 30 glaucoma patients (group 3) receiving three types of antiglaucoma eye drops. Controls comprised 75 eyes of 75 healthy volunteers. Subjective symptoms were evaluated by questionnaire, and lid margin and superficial punctate keratopathy were evaluated by slit lamp examination. Meibomian glands of upper and lower eyelids were observed and scored using noncontact meibography (meiboscore). Tear film break-up time (BUT) was measured and meibum was graded. Results: Lid margin abnormality, superficial punctate keratopathy, meiboscore, and meibum scores were significantly higher in glaucoma patients than in controls (P < 0.001). BUT and Schirmer scores were significantly lower in glaucoma patients than in controls (P < 0.001). Subgroup analysis of the parameters in group 1 revealed no significant difference between patients receiving prostaglandin and those receiving beta-blockers, or among groups 1, 2, and 3. Multivariate regression analysis demonstrated that meiboscore significantly correlated with lid margin abnormality score (P = 0.007) and BUT (P = 0.045) in group 1; with BUT (P = 0.004), symptom score (P = 0.003), and age (P = 0.026) in group 2; and with lid margin abnormality score (P = 0.001) in group 3. Conclusions: Long-term use of antiglaucoma eye drops was associated with alterations in meibomian gland morphology and function.