Effect of sodium hyaluronate on the pathochemical process in the anterior eye segment when using benzalkonium chloride eye drops in glaucoma patients
V.I. Senishin, MD
Danylo Halytsky Lviv National Medical University
Introduction.The purpose of the present paper was to study the effect of sodium hyaluronate on the pathochemical process in the anterior eye segment when using benzalkonium chloride eye drops in glaucoma patients
Material and Methods. The patients were divided into two groups: Control group consisted of 25 glaucoma patients being instilled Latanoprost with benzalkonium chloride (BAC); Study group consisted of 36 patients being additionally instilled 0.1% sodium hyaluronate solution for 6 months. In the tear fluid we determine the activity of lactate dehydrogenase (LD), glucose-6-phosphate dehydrogenase (G-6-PD), malate dehydrogenase (MDH), and acid phosphatase (ACP), as well as levels of thiol and disulfide groups .
Results. Data obtained in the studying of enzyme activity in the tear fluid of patients receiving hyaluronate instillations in addition to BAC eye drops indicate clearly the membrane-stabilizing action of hyaluronate. Meanwhile, hyaluronate did not influence significantly on reduced glutathione level in the tear, decreasing markedly the content of oxidized coenzyme.
Conclusions. Using hyaluronate in patients receiving BAC-containing antiglaucoma drugs has been shown to prevent destabilization of anterior segment membrane structure tissues. This is evidenced by a clear decrease in activity level of corresponding enzyme markers in the tear fluid. When using hyaluronate in patients receiving BAC-containing drops, thiol level in the tear fluid does not change significantly; this is the evidence of direct membrane trophic protective activity of hyaluronate from detergent action of the preservative.
Key words: antiglaucoma drugs, benzalkonium chloride, hyaluronate, anterior segment of the eye
1.Ivanova NV. [Preservatives in topic therapy of eye diseases: advantages and disadvantages]. Oftalmologiia. Vostochnaia Evropa. 2013.1(6):2-7. In Russian.
2.Ayaki M, Yaguchi S, Iwasawa A. Cytotoxicity of ophthalmic solution with and without preservatives to human corneal endothelial cells, epithelial cells and conjunctival epithelial cells. Clin. Exp. Ophthalmol. 2008;36:553-9.
3.Barki WH, M.Tahir. Effects of topical benzalkonium chloride on corneal epithelium. Biomedica. 2007; 23:65-70.
4.Lebedev OI, Kalizhnikova EA, Yavorsky AE. [Mechanisms of action and effects of the benzalkonium chloride on eye tissues]. Russkii med. zhurn. 2013(2): 63-5. In Russian.
5.Ammar DA, Noecker RJ, Kahook MY. Effects of benzalkonium chloride-preserved, polyquad-preserved, and sofZia-preserved topical glaucoma medications on human ocular epithelial cells. Adv. Ther. 2010; 27: 1-9.
6.Gaidamaka TB, Senishin VI. [Influence of the benzalkonium chloride on the oxidative-restored enzymes in the tissues of the anterior section of the eye]. Oftalmol Zh. 2013; 5: 61-6. In Russian.
7.Gaidamaka TB, Senishin VI. [Influence of the eye drop preservatives on the restorative potential of glutathione in the tissues of the anterior section of the eye]. Oftalmol Zh.2012;6:96-100. In Russian.
8.[New methods of biochemical analyses]. Izd. Leningradskogo univer.; 1991. 395 p. In Russian.
9.Nasledov A. [SPSS computer analysis of data in psychology and social studies]. St.-Petersburg: Piter Publ. 2005:416. In Russian.