Adverse Effects of Topical Antiglaucoma Medication

Broadway, David C; Grierson, Ian; O'Brien, C; Hitchings, Roger A.

doi:10.1001/archopht.1994.01090230060021

Cited by 453 publications

(255 citation statements)

References 25 publications

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“…BAK exposure has been linked to OSD, 5-11 macular edema, 27 and reduced success of glaucoma filtering surgery. 28 BAK induces cytotoxic effects leading to apoptosis in conjunctival cell culture, 29,30 and several studies have demonstrated detrimental effects on both conjunctival and corneal cells in rabbit models. [9][10][11] This potential interaction between BAK and OSD is clinically relevant, as a recent study estimated that approximately 60% of glaucoma patients have symptoms of OSD.…”

Section: Discussionmentioning

confidence: 99%

Travoprost 0.004%/timolol 0.5%-fixed combination with and without benzalkonium chloride: a prospective, randomized, doubled-masked comparison of safety and efficacy

Kitazawa

Smith

Sasaki

et al. 2011

Eye

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Section: Discussionmentioning

confidence: 99%

Travoprost 0.004%/timolol 0.5%-fixed combination with and without benzalkonium chloride: a prospective, randomized, doubled-masked comparison of safety and efficacy

Kitazawa

Smith

Sasaki

et al. 2011

Eye

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“…Long term topical medication, however, seems to have a negative influence on surgery (Richter et al 1988;Lavin et al 1990;Broadway et al 1994). A laser trabeculoplasty secondary to maximal medical treatment will result in an extended duration of combined topical therapy before subsequent operation may become necessary, with increased risk of encapsulation (Broadway et al 1994). This risk would be reduced by performing laser as a primary procedure.…”

Section: Discussionmentioning

confidence: 99%

The medium and long‐term efficacy of primary argon laser trabeculoplasty in avoiding topical medication in open angle glaucoma

Odberg

Sandvik

1999

Acta Ophthalmologica Scandinavica

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Results: The probability of treatment success (no medication required) was for chronic open angle glaucoma 77% after 2 years, 67% after 5 years and 67% after 8 years. Corresponding numbers for pseudoexfoliation glaucoma were 80%, 54% and 36%. Prelaser IOP higher than 31 mmHg, pretreatment visual field defect and sparse pigmentation of the trabecular meshwork were independent predictors of failure. Conclusion: Primary argon laser trabeculoplasty gives a long-lasting and favourable effect in chronic open angle glaucoma where 2/3 of the eyes still managed without additional medication for 8 years. The success in pseudoexfoliation glaucoma was even higher the first 3 years, and kept above 50% for 5 years. This makes laser a valuable option as first choice of therapy in glaucoma.Key words: open angle glaucoma -pseudoexfoliation glaucoma -argon laser trabeculoplastyprimary treatment -long-term results -quality of life.

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“…12 While some shortening of the conjunctival fornix occurs with age, this is increased by topical therapy. 10 In these patients, fibroblasts, macrophages, lymphocytes, and mast cells are present in the superior conjunctival substantia propria 11 and there is a loss of goblet cells in the epithelium.…”

Section: Pathogenesismentioning

confidence: 99%

Corneal toxicity: the epithelium and stroma in iatrogenic and factitious disease

Dart

2003

Eye

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Corneal toxicity is caused by chemical trauma and by iatrogenic and factitious disease, which are often overlooked, and which are reviewed here. The clinical signs of iatrogenic disease are usually nonspecific and identical to those resulting from other causes of surface disease. Factitious disease is either the result of mechanical trauma or the abuse of toxic eye drops. One epidemiological study, in a tertiary setting, identified 13% of keratoconjunctivitis cases as iatrogenic. Healing was prolonged taking 7-93 (median 28.5) days. Pathogenic mechanisms vary widely with different drugs and include subclinical scarring, pseudopemphigoid, drug-induced ocular cicatricial pemphigoid, and toxic follicular reactions. There is little readily available data either on the probability of the development of adverse reactions or for the comparison of different drugs. The assessment of the toxicity of topical drugs is currently by the Draize test in rabbits. New in vitro tests on human corneal epithelial cell cultures include ATP assays for cell viability, scanning EM of epithelial microvilli, and vital staining to assess cell membrane permeability and intracellular esterase. Despite their simplicity, these test systems can correlate well with clinical toxicity and provide a toxicity index for drug comparisons. Treatment requires drug withdrawal or substitution by nonpreserved and less toxic preparations. Factitious injury is rare, difficult to diagnose, and should only be considered when all other diagnoses have been excluded. Prevention requires a high level of awareness of the potential for iatrogenic disease, particularly in the high-risk setting of chronic ocular surface disease.

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Adverse Effects of Topical Antiglaucoma Medication

Cited by 453 publications

References 25 publications

Travoprost 0.004%/timolol 0.5%-fixed combination with and without benzalkonium chloride: a prospective, randomized, doubled-masked comparison of safety and efficacy

Travoprost 0.004%/timolol 0.5%-fixed combination with and without benzalkonium chloride: a prospective, randomized, doubled-masked comparison of safety and efficacy

The medium and long‐term efficacy of primary argon laser trabeculoplasty in avoiding topical medication in open angle glaucoma

Corneal toxicity: the epithelium and stroma in iatrogenic and factitious disease

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