Ocular factors relevant to keratoepitheliopathy in glaucoma patients with and without diabetes mellitus

Purpose: To examine the effect of diabetes mellitus on the keratoepitheliopathy in glaucoma patients with and without diabetes mellitus who were treated with anti-glaucoma eye drops. Methods: The presence and severity of keratoepitheliopathy was investigated in the eyes of 36 glaucoma patients with diabetes mellitus and 47 nondiabetic patients who had glaucoma. All the patients had used anti-glaucoma eye drops. The ocular factors examined were the status of the lipid layer of the tear fluid assessed by a specular reflection video recording system, the tear volume assessed by the Schirmer test, and the tear film stability assessed by tear break-up time (BUT). Results: The incidence of superficial punctate keratitis (SPK) was 36.1% in the diabetic patients with glaucoma and 27.7% in the nondiabetic patients with glaucoma. Serious cases of SPK were seen only in the diabetic patients with glaucoma. The uniformity of the tear lipid layer, results of the Schirmer test, and the tear BUT in the diabetic patients with glaucoma were similar to those in the nondiabetic patients with glaucoma. Conclusion: In glaucoma patients who use anti-glaucoma eye drops, the effects of diabetes mellitus on the keratoepitheliopathy and other ocular factors are not significant. However, we must consider the serious cases of keratoepitheliopathy in these patients.