REVERSAL OF TOPICAL ANTIGLAUCOMA MEDICATION EFFECTS ON THE CONJUNCTIVA

Objective: To determine whether the adverse effects of antiglaucoma me dications could be reversed before filtration surgery, potentially red ucing the risk of subsequent failure. Methods: One month before surger y, 30 patients who were receiving multiple antiglaucoma medications un derwent an inferior bulbar conjunctival biopsy, ceased using sympathom imetic drops, and began treatment with topical corticosteroid, (1% flu orometholone four times daily). At the time of surgery two conjunctiva l biopsy specimens were obtained, one from the operation site (superio r bulbar region), and one from the inferior bulbar region. The biopsy specimens were quantitatively analyzed by light microscopy. In additio n, the outcome of first trabeculectomy for 16 of these patients was co mpared with that of 16 matched patients who had not undergone an alter ed preoperative regimen of topical therapy. Results: During a 1-month period a notable decrease occurred in the number of fibroblasts and in flammatory cells throughout the conjunctiva. Inferior bulbar conjuncti va was found to be representative of superior bulbar conjunctiva with respect to these changes. Furthermore, evidence comparing the matched patients suggested that the altered preoperative regimen may have impr oved the success rare of trabeculectomy. Conclusions: The preoperative regimen used reversed the adverse conjunctival effect of topical medi cation. The regimen may be of clinical benefit in improving the succes s rate of trabeculectomy.