AI Article Synopsis
- Glaucoma filtering surgery often fails due to fibrosis at the episcleral-conjunctival interface.
- Sherwood et al proposed that chronic use of topical antiglaucoma medications may lead to increased inflammatory cells in the conjunctiva, potentially raising the risk of fibrosis and bleb failure.
- A pilot study in rabbits showed no significant change in inflammatory cell numbers or fibroblast activity after long-term use of timolol, pilocarpine, and epinephrine, suggesting that longer treatment or surgery may be needed to assess their effects on the conjunctival tissue.
Article Abstract
Glaucoma filtering surgery fails most frequently due to fibrosis at the episcleral-conjunctival/Tenon's capsule interface. Sherwood et al have suggested that chronic topical antiglaucoma medications increase conjunctival inflammatory cells, which could increase the likelihood of fibrosis and subsequent bleb failure. In a pilot study in a rabbit model, we placed timolol, pilocarpine, and epinephrine, or a combination of all three, in one eye of 24 animals twice daily for 7 months. The fellow eye received distilled water. Microscopic examination revealed no statistically significant change in the number of acute or chronic inflammatory cells, fibroblasts, or goblet cells in the treated as compared with the control eyes. A longer duration of drug administration, or drug administration followed by surgical intervention, may be required to produce an effect on the conjunctiva and Tenon's capsule, if such an effect exists.
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