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  Vol. 112 No. 11, November 1994 TABLE OF CONTENTS
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Adverse Effects of Topical Antiglaucoma Medication

I. The Conjunctival Cell Profile

David C. Broadway, FRCOphth; Ian Grierson, PhD; Colm O'Brien, FRCOphth; Roger A. Hitchings, FRCOphth

Arch Ophthalmol. 1994;112(11):1437-1445.


Abstract



Objective
To determine the effect of various long-term topical antiglaucoma regimens on the cell population profile of the conjunctiva.

Methods
Conjunctival biopsy specimens from 124 patients undergoing filtration surgery were assessed quantitatively by light microscopy. Preoperatively, the patients had used a drug for only a brief period (group A; n=28), a β-blocker alone (group B; n=31), a β-blocker in combination with a miotic (group C; n=33), or a combination of β-blocker, miotic, andsympathomimetic (group D; n=32).

Results
The conjunctiva in groups A and B was similar. Group C conjunctiva differed, but the changes were most marked in biopsy specimens from patients in group D, where there was a significant decrease in goblet cells (P<.05); increase in pale cells, macrophages, and lymphocytes within the epithelium (P<.001); and increase in fibroblasts (P<.001), macrophages (P<.001), mast cells (P<.05), and lymphocytes (P=.01) in the substantia propria. In addition, the effect of duration of therapy was assessed. Administration of topical medication for more than 3 years was found to increase the numbers of pale cells within the epithelium (P<.05); fibroblasts (P<.05), macrophages (P<.001), lymphocytes (P<.01), and mast cells (P=.001) within the superficial substantia propria; and the numbers of fibroblasts (P=.01) and macrophages (P<.05) within the deep substantia propria.

Conclusions
The compared treatment regimens affected the conjunctiva to different degrees, with multipledrug topical therapy exerting the greatest effect on the degree of subclinical inflammation within the conjunctiva. The results also indicated that administration of topical medication, irrespective of type, for 3 years or more induced a significant degree of subclinical inflammation.



Author Affiliations



From Moorfields Eye Hospital, London, England (Drs Broadway and Hitchings); Department of Clinical Science, Institute of Ophthalmology, London (Drs Broadway and Grierson); Department of Experimental Ophthalmology, University of Liverpool (England) (Dr Grierson); and St Pauls Eye Hospital, Liverpool (Dr O'Brien).


Footnotes



The authors have no commercial, financial, or proprietary interest in any of the products or companies mentioned in this study.



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