Adverse effects of topical antiglaucoma medication. I. The conjunctival cell profile

Arch Ophthalmol. 1994 Nov;112(11):1437-45. doi: 10.1001/archopht.1994.01090230051020.


Objective: To determine the effect of various long-term topical antiglaucoma regimens on the cell population profile of the conjunctiva.

Methods: Conjunctival biopsy specimens from 124 patients undergoing filtration surgery were assessed quantitatively by light microscopy. Preoperatively, the patients had used a drug for only a brief period (group A; n = 28), a beta-blocker alone (group B; n = 31), a beta-blocker in combination with a miotic (group C; n = 33), or a combination of beta-blocker, miotic, and sympathomimetic (group D; n = 32).

Results: The conjunctiva in groups A and B was similar. Group C conjunctiva differed, but the changes were most marked in biopsy specimens from patients in group D, where there was a significant decrease in goblet cells (P < .05); increase in pale cells, macrophages, and lymphocytes within the epithelium (P < .001); and increase in fibroblasts (P < .001), macrophages (P < .001), mast cells (P < .05), and lymphocytes (P = .01) in the substantia propria. In addition, the effect of duration of therapy was assessed. Administration of topical medication for more than 3 years was found to increase the numbers of pale cells within the epithelium (P < .05); fibroblasts (P < .05), macrophages (P < .001), lymphocytes (P < .01), and mast cells (P = .001) within the superficial substantia propria; and the numbers of fibroblasts (P = .01) and macrophages (P < .05) within the deep substantia propria.

Conclusions: The compared treatment regimens affected the conjunctiva to different degrees, with multiple-drug topical therapy exerting the greatest effect on the degree of subclinical inflammation within the conjunctiva. The results also indicated that administration of topical medication, irrespective of type, for 3 years or more induced a significant degree of subclinical inflammation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Topical
  • Adolescent
  • Adrenergic beta-Antagonists / administration & dosage
  • Adrenergic beta-Antagonists / adverse effects*
  • Adult
  • Aged
  • Aged, 80 and over
  • Conjunctiva / drug effects*
  • Conjunctiva / pathology
  • Conjunctivitis / chemically induced
  • Conjunctivitis / pathology
  • Drug Therapy, Combination
  • Female
  • Filtering Surgery
  • Glaucoma, Open-Angle / drug therapy*
  • Glaucoma, Open-Angle / surgery
  • Humans
  • Male
  • Middle Aged
  • Miotics / administration & dosage
  • Miotics / adverse effects*
  • Ophthalmic Solutions
  • Sympathomimetics / administration & dosage
  • Sympathomimetics / adverse effects*


  • Adrenergic beta-Antagonists
  • Miotics
  • Ophthalmic Solutions
  • Sympathomimetics