Do prostaglandin analogs affect eyelid position and motility?

Purpose: The authors aim at investigating the possible clinical effects of topical Prostaglandin Analogs on eyelid position and motility with this single masked protocol in a cross-sectional study.

Methods: A group (group A) of 182 patients on treatment for glaucoma with prostaglandin analogs (latanoprost, travoprost, and bimatoprost) and a group of 191 age-matched normal controls (group B) were enrolled in the study. Group A was subdivided into 3 subgroups according to the prostaglandin analogs used by the patients. Group A1: 84 patients on latanoprost, group A2: 56 patients on travoprost, and group A3: 42 patients on bimatoprost. Two positive control groups (group H of 115 patients with lower lid involutional entropion or ectropion secondary to horizontal lid laxity (HLL), and a group P of 137 patients with involutive aponeurotic blepharoptosis) were also enrolled in the study. For the upper eyelid, the following parameters were measured: margin-reflex distance (MRD), upper lid crease position, levator function. For the lower lid, the following parameters were used: HLL and lower lid excursion (LLE). Statistical analysis of the data was done to assess whether there was any statistical significant difference for each of the parameter between group A (and its subgroups) and, respectively, groups B, H, and P. Similarly, it was also compared with group B, with group H, and then with group P. Analysis of variance of the eyelid parameters was also carried out in the 3 subgroups A1, A2, and A3.

Results: There was no statistically significant difference for each studied parameter between group B and, respectively, groups A1, A2, A3 and group A, nor there was any statistically significant variance between parameters in the 3 subgroups A1, A2, and A3. The accuracy of the eyelid parameters was confirmed while obtaining statistically significant differences in LLE (P<0.05) and in HLL (P<0.001) comparing group A (and its subgroups) and group H and also in MRD and upper lid crest (P<0.001) comparing group A (and its subgroups) and group P.

Conclusions: There is no evidence that prostaglandin analogs significantly affect the eyelids' tissues to produce eyelid malposition.