The Association of Chronic Topical Prostaglandin Analog Use With Meibomian Gland Dysfunction

J Glaucoma. 2016 Sep;25(9):770-4. doi: 10.1097/IJG.0000000000000495.


Purpose: To evaluate the association of long-term prostaglandin analog (PGA) use with meibomian gland dysfunction (MGD) in medically treated glaucoma patients.

Materials and methods: This was a prospective cross-sectional study conducted at a single academic setting. In total, 70 eyes of 70 patients with a medical diagnosis of glaucoma who were on long-term (>12 mo) topical hypotensive medication(s) were included. Patients were classified based on whether they were on PGA or non-PGA class of medication(s). MGD was defined based on meibomian gland terminal duct obstruction and graded between 1 and 5 based on severity. For all subjects, ocular surface disease index questionnaire, break-up time, lissamine green staining, and Schirmer test (under topical anesthesia) was administered. Student t test, Mann-Whitney U test, and χ test was used in statistical evaluations. Forty-five age-matched healthy control subjects who were not on any topical medications were also included.

Results: In total, 25 patients (35.7%) were on PGA monotherapy, 21 (30.0%) were treated with fixed or unfixed PGA combination regimens, and 24 (34.3%) were on non-PGA medications. MGD prevalence was higher in patients treated with PGA monotherapy (92.0%) compared with those receiving non-PGA therapy (58.3%) (P=0.02). Obstructive type of MGD was detected in the majority of patients treated with PGAs (95.7%). Grade 2 and 3 MGD was noted in 80.5% of patients on PGA. Patients on PGA had worse ocular surface disease index and ocular surface test results (P<0.001) compared with those of control subjects.

Conclusions: Long-term administration of PGA is associated with obstructive type of MGD.

MeSH terms

  • Administration, Topical
  • Aged
  • Aged, 80 and over
  • Antihypertensive Agents / adverse effects*
  • Cross-Sectional Studies
  • Eyelid Diseases / chemically induced*
  • Eyelid Diseases / diagnosis
  • Female
  • Glaucoma / diagnosis
  • Glaucoma / drug therapy*
  • Humans
  • Intraocular Pressure / physiology
  • Male
  • Meibomian Glands / drug effects*
  • Meibomian Glands / pathology
  • Middle Aged
  • Ophthalmic Solutions
  • Prospective Studies
  • Prostaglandins, Synthetic / adverse effects*
  • Surveys and Questionnaires


  • Antihypertensive Agents
  • Ophthalmic Solutions
  • Prostaglandins, Synthetic