Abstract
Long-term use of topical drugs can induce changes in theconjunctiva and ocular surface. To determine theconjunctival changes resulting from topical glaucomamedication, patients with glaucoma were selected andclassified into seven groups, according to the medicationreceived: 24 eyes were treated with betaxolol, 20 eyes withlevobunolol, 32 eyes with timolol maleate, 22 eyes withpilocarpine, 52 eyes with beta-blocker and pilocarpine, 34eyes with beta-blocker and dipivefrin, and 32 eyes withmaximum therapy. Patients who were under 18 wereexcluded, as were those with any history of ocular surgeryand other interventions, long-term use of any topicallyadministered medication except glaucoma drugs, and anyhistory or slit-lamp examination evidence of ocular surfacedisorders. The changes in the conjunctiva of 216 eyes wereevaluated by means of ocular surface impression cytology.The medication group showed statistically significant degreesof conjunctival metaplasia when compared to the controlgroup (p < 0.01). The cytological grading was not correlatedwith age, sex, type of medication, duration of topicaltreatment or the number of drugs (p > 0.05). Duration oftreatment exceeding three months was not correlated withcytological grading. Thus, as far as surgical treatment wasconcerned, it was concluded that intervention within the firstthree months after the diagnosis would be most beneficial inthe management of glaucoma.The fact that the presence of the preservative benzalkoniumchloride was the same in all preparations suggests that itmay be the major factor in conjunctival metaplasia.
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Turaçli, E., Budak, K., Kaur, A. et al. The effects of long-term topical glaucoma medication on conjunctival impression cytology. Int Ophthalmol 21, 27–33 (1997). https://doi.org/10.1023/A:1005892426045
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DOI: https://doi.org/10.1023/A:1005892426045