Topical medications have a very important role in chronic glaucoma treatment. Long-term use of these medications can cause significant changes on ocular surfaces. In this study, the ocular surfaces of 20 control subjects (group I), 20 primary open-angle glaucoma patients (group II) treated (mean 21.20 +/- 1.32 months) with 0.50% timolol maleate, and 20 primary open-angle glaucoma patients (group III) treated (mean 21.70 +/- 1.34 months) with 0.50% timolol maleate + 1% dipivefrin hydrochloride were evaluated. Studied parameters included Schirmer's test, tear break-up time, conjunctiva impression cytology and goblet cell density. These results suggest that long-term applications of topical anti glaucoma medications damage the ocular surface.
The complications of repeated surgery may reduce final graft clarity and visual acuity; the disease process necessitating regrafting may carry a poorer prognosis for sight.
Therapeutic PK is effective in the management of the eye with active uncontrolled infection or perforation from corneal disease. Approximately half of our patients maintained a clear graft at the last visit. Without therapeutic surgery, these eyes would have been lost.
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