“INFLUENZA DELLA TERAPIA CON TIMOLOLO maleato 1mg/g gel oftalmico (TIMOGEL) SULLE STRUTTURE CORNEALI: VALUTAZIONE CON MICROSCOPIA CONFOCALE, CONFOSCAN 3

The Confoscan 3 is a new diagnostic tool used to evaluate microscopic and morphological aspects of the cornea in vivo. We used the Confoscan 3 (CS£) to evaluate the microscopic corneal findings in patients with open angle glaucoma in therapy with Timogel Objective of the study: In vivo evaluation of microscopic corneal changes in patients while in theraphy with timolole maleate 1mg/g ophthalmic gel using confocal microscopy (CS3) Materials and methods: We examined 20 patients with monocular hypertension (OH) that never had topic antiglaucoma drugs and their 20 contralateral eyes. Inclusion criteria were: a monocular IOP>21 mmHg, corneal thickness between 500 and 550 µm, Shaffer class IV irido-corneal angle, any corneal disease, refractive error between -3 and +3 dptr, never used contact lenses, never treated with hypotonizing drugs, never had ocular surgery, age <50 years, any sistemic disease. After a complete opthalmological evaluation a corneal examination was performed with CS3 before the begining of the theraphy and subsequentely 1 and 3 months after the beginning of the theraphy with timolole maleate 1mg/g ophthalmic gel. The subjects used timolole maleate 1mg/g ophthalmic gel once a day only in the affected eye, and a placebo in the control eye. We performed Shirmer test before the begining of the theraphy and susequentely 1 and 3 months after the beginning of the theraphy. The corneal thickness was measured by ultrasound pachimetry Results: We obtained in the treated eyes a significative reduction in IOP values and steady IOP in the follow up. The analysis of corneal endothelium did not show any significative difference between groups, neither were evidenced stromal qualitative or quantitative changes. Any significative modification of sromal or epitelial reflectivity was noted. The corneal average thtickness variations between eyes was not significative. Conclusions: The examination with CS3 allovs the clinician to study in a non invasive way the corneal microcscopic structures and allowed us to evidence that topic theraphy with timolole maleate 1mg/g ophthalmic gel does not produce any significative corneal morphologic change.