Changes in ocular surface caused by antiglaucomatous eyedrops: prospective, randomised study for the comparison of 0.5% timolol v 0.12% unoprostone

Aim-To study changes induced in ocular surface epithelia and the tear film by antiglaucomatous eyedrops. A beta blocker (0.5% timolol) and a novel pro staglandin F-2 alpha metabolite related drug (0.12% unoprostone) were exami ned in a prospective, randomised fashion. Methods-40 patients were randomly assigned to use either 0.5% timolol (timo lol group) or 0.12% unoprostone eyedrops (unoprostone group) twice a day fo r 24 weeks. In addition to routine ocular examinations, corneal epithelial integrity (vital staining tests, tear film break up time (BUT), anterior fl uorometry, specular microscopy) and tear function (Schirmer's test, cotton thread test, tear clearance test (TCT)) were examined before and after the treatment. Results-Both eyedrops caused significant reduction in intraocular pressure from the baseline levels. No significant changes were noted in corneal inte grity in both groups, except a decrease in BUT at 20 weeks in the timolol g roup. The timolol group demonstrated significant decreases in Schirmer's te st, tear clearance test, and tear function index (Schirmer's test value mul tiplied by clearance test); however, no such changes were noted in the unop rostone group. Conclusion-While unoprostone eyedrops caused no adverse effects on the corn eal epithelial integrity and tear function, timolol caused significant impa irments in tear production and turnover.