Comparison of the goblet cells’ density and the quality of tears in treatment with sodium hyaluronate 0.1% benzalkonium chloride preservative-free eye drops for patients with glaucoma and dry-eye syndrome: A double-blind randomized clinical trial

Artini, Widya; Hasudungan, V. C.; Susiyanti, Made; Prihartono, Joedo; Gondhowiardjo, Tjahyono D.

doi:10.1088/1742-6596/1073/3/032075

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“…BAK has detergent molecule, which disrupts lipid layer of bacteria, so it works as preservative but also disrupts lipid layer of ocular surface and lipid layer of tear film. This effect induces inflammation by increasing tumor necrosing factor(TNF), interleukin (IL)-1,5IL-10, IL-2 and C-reactive protein (CRP) (Georgiev et al, 2011;Kaštelan et al, 2013;Artini et al, 2018).Disrupted tear lipid layer causing TBUT to decrease, and the layer below, the aqueous layer, tends to have more evaporation. On the other hand, inflammation on ocular surface also increase tear osmolarity and corneal epithel neurotoxixity then induces vicious scircle on lacrimal gland causing decreased aqueous production of tear film and those mechanism could alter the S-1 test (Rosin and Bell, 2013;Marques et al, 2015;Fidalia, Bahar and Rizki, 2019).…”

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confidence: 99%

The Effect of Topical Medication Containingbenzalkoniumchloride on Ocular Surface Disease Inglaucoma Patients

Nurwasis¹,

Wulandari²,

Lutfi³

2020

IJPR

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Background, The main cause of the emergence of dry eye and ocular surface disease (OSD) is strongly suspected due to the preservative component of topical medication in the form of benzalkonium chloride (BAK).Various complaints such as uncomfortable, teary, redness, burning and foreign object sensation, glare, often blinking and intermittent blurred vision has-been reported as part of OSD. Objective:The study aimed to investigate the effect of topical medication containing BAK on ocular OSD in glaucoma patients Method: Subject who has been using topical antiglaucomatous medication containing BAK and artificial tears were examined for tear film break up time (TBUT), S I test and corneal staining. Sucject were allowed to close the eyes, then positioned in front of the slit-lamp biomicroscope. Regression test was used to analyze the correlation between each variable.Result: TBUT and S I test were decreased, and corneal staining score was increased, furthermore, BAK is significantly correlated with all of the examination result by using regression test. The effect of the amount and duration of BAK used is significantly correlated with TBUT (p = 0.004). The effect of the amount and duration of BAK used insignificantly correlated with S I test (p = 0.043). This study also has R value as 0.901; >0.05, shows the amount and duration of BAK used is strongly affect TBUT, S I test and corneal staining score. Conclusion: BAK has strong correlation on the event of ocular surface disease.Keywords---benzalkonium chloride, glaucoma, ocular surface disease, Schirmer I test, corneal staining. I. INTRODUCTIONGlaucoma is reportedly the leading cause of irreversible blindness in the world, affecting >70 million people worldwide (Leung, Medeiros and Weinreb, 2008).This disease is caused by a group of optic neuropathies that lead to progressive degeneration of retinal ganglion cells. Damage to these neurons results in what is called ''cupping'' of the optic disk and vision loss (Halasz et al., 2019).The main treatment of glaucoma is the use of topical medication, and often can't be treated with a single treatment. In a data from the use of topical medication in patients with

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