[Conjunctival changes related to topical treatment and effectiveness of surgery in glaucoma].
OBJECTIVE
The topical treatment for a long run in glaucoma rises histopathological changes of conjunctiva. The study is aimed at assessing the correlations between conjunctival changes bound of the type and duration of medical glaucoma therapy and the efficiency of subsequent filtering surgery.


METHODS
For this purpose, we carried out a three years clinical prospective study (01.05.2000-30.04.2003), with a mean follow-up period of 18.5 months, enrolling 22 cases (38 eyes) operated by trabeculectomy for primary open angle glaucoma (POAG), with the same technique and the same surgeon. There were excluded both the patients with previous ophthalmic surgical interventions and ocular/systemic chronic inflammatory disease. The cases were divided according to type and duration of topical treatment. There were recorded the conjunctival changes (by histological exam and immunohistochemistry), dynamic evolution of intraocular pressure (IOP) and the morphological aspects of filtering blebs. Statistical analysis was performed by Wilcoxon test.


RESULTS
In all groups, the efficiency of filtering surgery was correlated with the duration of topical medication; the survey presents the correlations between topical treatment, conjunctival changes and postoperative evolution.


CONCLUSIONS
These results suggest that exhaustive topical treatment in POAG, for a long period, with many drugs may represent a negative prognostic factor for the subsequent filtering surgery. Therefore it is necessary an individual approach for the first line therapy in POAG.
Stefan
C
C
Institutul Naţional de Cercetare şi Dezvoltare în Domeniul Patologiei şi Stiinţelor Biomedicale, V. Babeş, Bucureşti.
Nenciu
A
A
Balas
Mihaela
M
Neacşu
Alina
A
Dachin
Luminiţa
L
Ardelean
Carmen
C
D000287:Administration, Topical; D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000009:adverse effects; D001706:Biopsy; D003228:Conjunctiva / Q000187:drug effects* / Q000473:pathology; D003229:Conjunctival Diseases / Q000139:chemically induced* / Q000473:pathology; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D011446:Prospective Studies; D011453:Prostaglandins / Q000008:administration & dosage / Q000009:adverse effects; D018709:Statistics, Nonparametric; D014130:Trabeculectomy / Q000379:methods; D016896:Treatment Outcome
D000319:Adrenergic beta-Antagonists; D011453:Prostaglandins