Evaluation of Adverse Effects of Topical Glaucoma Medications on Trabeculectomy Outcomes Using the Glaucoma Medications Intensity Index

Abstract

Introduction:Trabeculectomy is commonly performed for glaucoma when medications are unable to control disease progression or have intolerable adverse effects. Previous studies have suggested that a higher number of and/or longer treatment duration with preoperative topical glaucoma medications are associated with a higher risk of trabeculectomy failure, but most of these studies lack quantification of exposure. The aim of this study was to investigate the relationship between preoperative exposure to topical glaucoma medications and trabeculectomy outcome, using a new method for quantifying accumulated exposure. Methods: Consecutive patients with primary open-angle glaucoma (POAG) or normal-tension glaucoma (NTG) who underwent primary trabeculectomy between 2013 and 2017 were retrospectively reviewed. The Glaucoma Medications Intensity Index (GMII) was calculated for each eye by multiplying the number of drops per week by duration of use (in years). The

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Surgical Outcomes of Glaucoma Drainage Device Implantation in Refractory Glaucoma Patients in Thailand

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“…Preservatives in topical glaucoma medications, such as polyquaternium-1 (PQ-1) and benzalkonium chloride (BAK), may disrupt the ocular surface, activate proinflammatory cytokines, cause squamous metaplasia of the conjunctival epithelium, fibrosis of Tenon’s capsule, and decrease the number of goblet cells [ 217 , 218 ]. The long-term use of topical medications may induce subclinical or clinical conjunctival inflammatory changes and reduce the success rate of GFS [ 219 ]. The cornea is a major part of the ocular surface and is a tissue that undergoes minute remodeling during homeostasis.…”