The influence of local IOP-lowering therapy on the anterior segment tissues and outcome of glaucoma filtering surgery

Abstract

Nowadays, a wide choice of local IOP-lowering medications allows ensuring a successful intraocular pressure compensation and primary open angle glaucoma stabilization. However, taking into consideration a long term action of drugs on the ocular surface, even without clinical manifestations there is a direct inflammatory cells’ activation with mixed toxic and allergic changes, which is confirmed by histology, immune-histology, and impression cytology methods. Such chronic sub-clinical inflammation represent a potential risk of excessive fibroblast proliferation with subsequent rapid postoperative scarring of new outflow pathways and atypical filtration bleb formation. It is shown that there is a clear relationship between number of glaucoma drugs used, treatment duration, intensity of conjunctival infiltration with inflammatory cells and fibroblasts, and risk of episcleral fibrosis and subconjunctival scarring during post-op period.

Keywords

primary open-angle glaucoma / inflammation / ocular surface / post- surgical scarring

References

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Petrov S.Y., Lovpache D.N., Loskutov I.A., Safonova D.M.