Efficacy of indomethacin 0.1% and fluorometholone 0.1% on conjunctival inflammation following chronic application of antiglaucomatous drugs

Baudouin, Christophe; Nordmann, Jean‐Philippe; Denis, Philippe; Creuzot‐Garcher, Catherine; Allaire, Catherine; Trinquand, C.

doi:10.1007/s00417-002-0581-9

Cited by 42 publications

(19 citation statements)

References 19 publications

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“…Broadway et al [40] used conjunctival biopsies to assess preoperative inflammation, and found fluorometholone efficient one month prior to surgery to decrease inflammatory infiltrates and improve surgical outcome, but this technique remains difficult to propose on a routine basis. Baudouin et al [41] used impression cytology specimens to measure inflammation in the conjunctival epithelium and also found that a preservativefree nonsteroidal anti-inflammatory agent could decrease inflammation prior to surgery but no correlation was made with success rates. Nevertheless, both preoperative anti-inflammatory strategies were found similarly effective in improving the prognosis of glaucoma surgery [42].…”

Section: Preoperative Assessment Of Failure Riskmentioning

confidence: 98%

Ocular Surface and External Filtration Surgery: Mutual Relationships

Baudouin¹

2012

Developments in Ophthalmology

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There is a large body of evidence from clinical and experimental studies that the long-term use of topical drugs may induce ocular surface changes, causing ocular discomfort, dry eye, conjunctival inflammation, subconjunctival fibrosis, corneal surface impairment, and, as a consequence of chronic ocular surface changes, the potential risk of failure for further glaucoma surgery. Subclinical inflammation has also been widely described in patients receiving antiglaucoma treatments for long periods of time, with inflammatory cell infiltration and fibroblast activation in the conjunctiva and subconjunctival space. The preservative, especially benzalkonium chloride, which has consistently demonstrated its toxic effects in laboratory, experimental, and clinical studies, could induce or enhance such inflammatory changes. As a quaternary ammonium, this compound causes tear film instability, loss of goblet cells, conjunctival squamous metaplasia and apoptosis, disruption of the corneal epithelium barrier, corneal nerve impairment, chronic inflammation and potential damage to deeper ocular tissues. Drug-induced adverse effects are therefore far from being restricted to only allergic reactions, but they are often very difficult to identify because they mostly occur in a delayed or poorly specific manner, and result from complex and multifactorial interactions between the drugs and the ocular surface. Postoperatively, the ocular surface also plays an important role, as the conjunctiva interacts with aqueous humor and subconjunctival fibrosis may block aqueous outflow and cause surgical failure. As preoperative inflammation underlies postoperative fibrosis and therefore surgical outcome, a better knowledge of ocular surface changes with appropriate evaluation and management should thus become a new paradigm in glaucoma care over the long term.

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Section: Preoperative Assessment Of Failure Riskmentioning

confidence: 98%

Ocular Surface and External Filtration Surgery: Mutual Relationships

Baudouin¹

2012

Developments in Ophthalmology

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“…In einer prospektiven Studie, die Indomethacinvs. Fluorometholon-Augentropfen 4 Wochen vor Trabekulektomie miteinander verglich, zeigte sich ein gleich guter antientzündlicher Effekt [7].…”

Section: Perioperative Antientzündliche Therapie Im Rahmen Der Glaukounclassified

Perioperative antientzündliche Therapie im Rahmen der Glaukomchirurgie

Dietlein

Erb²

2019

Klin Monatsbl Augenheilkd

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ZusammenfassungViele klinische Studien belegen, dass der funktionelle Ausgang der Glaukomchirurgie, insbesondere der Filtrationschirurgie, durch eine topische antientzündliche Vor- und Nachbehandlung signifikant beeinflusst werden kann. Die topischen Steroide erweisen sich sowohl in der Vor- als auch in der Nachbehandlung nach Trabekulektomie als günstig, wobei die Dauer der postoperativen Behandlung vom individuellen Befund abhängig gemacht werden soll. Eine systemische Steroidtherapie oder Immunmodulation ist beim uveitischen Sekundärglaukom für den Erfolg der Glaukomchirurgie signifikant von Bedeutung, bei anderen Glaukomformen ist ein Nutzen der systemischen Therapie nicht belegt. Eine zusätzliche topische Therapie mit nicht steroidalen Antiphlogistika ist bei einer kombinierten Katarakt-Glaukom-Chirurgie zu erwägen. Eine topische antientzündliche Therapie nach selektiver Lasertrabekuloplastik ist nicht notwendig, bei Argonlasertrabekuloplastik und Zyklophotokoagulation wirkt diese sich schmerzlindernd aus. Die intravitreale Gabe von Steroiden im Rahmen der Glaukomchirurgie muss aufgrund der Induktion von Augendruckspitzen immer kritisch abgewogen werden.

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“…Besides intra-and post-operative administration, some studies have highlighted the beneficial effect of preoperative use of corticosteroids and non steroidal anti-inflammatory agents in improving the success rate of filtration surgery. Baudouin demonstrated that fluorometholone drops one month before filtering surgery has effectively reduced inflammation, as indicated by the expression of human leukocyte antigen (HLA)-DR after impression cytological analysis (Baudouin 2002). Breusegem compared preoperative topical anti-inflammatory medications to placebo before trabeculectomy.…”

Section: Corticosteroidsmentioning

confidence: 99%

Update on Modulating Wound Healing in Trabeculectomy

Sheha¹

2011

Glaucoma - Basic and Clinical Concepts

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Efficacy of indomethacin 0.1% and fluorometholone 0.1% on conjunctival inflammation following chronic application of antiglaucomatous drugs

Cited by 42 publications

References 19 publications

Ocular Surface and External Filtration Surgery: Mutual Relationships

Ocular Surface and External Filtration Surgery: Mutual Relationships

Perioperative antientzündliche Therapie im Rahmen der Glaukomchirurgie

Update on Modulating Wound Healing in Trabeculectomy

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