Local effect of previou conjunctival inciional urgery and the ubequent outcome of filtration urgery Original Reearch Article

Purpoe: Previou ocular urgery involving conjunctival inciion i a rik factor for failure of filtration urgery. To determine whether uing adjunctive antimetabolite therapy may have a rational bai, a tudy wa performed to determine whether the conjunctival cellular profile wa altered by uch urgery. Method: After a mean follow-up of 5.9 year, filtration urgery outcome for 35 patient who had undergone conjunctival inciional urgery were retropectively compared with 29 control and 18 matched patient who had not undergone uch urgery. At the time of filtration urgery, a conjunctival biopy pecimen wa obtained from all 82 patient, and thee were quantitatively analyzed by light microcopy in a propective manner. Reult: Trabeculectomy ucce for the control group (93%) wa ignificantly higher than for the previou urgery group (38%) (P < .001). Compared with control tiue, conjunctiva from the patient who had undergone previou urgery contained more fibroblat (P < .001, P < .05), macrophage (P < .01, P < .001), and lymphocyte (P = .001, P < .01) in both uperficial and deep ubtantia propria (repective P value). Furthermore, trabeculectomy failure wa aociated with an increae in number of conjunctival fibroblat in intraoperative pecimen. Concluion: Previou ocular urgery involving the conjunctiva increae the number of conjunctival fibroblat and inflammatory cell. Thi may account for the increaed rik of trabeculectomy failure. Perhap on thi bai, the ue of adjunctive medication may be jutified in patient who have undergone previou ocular urgery involving conjunctival inciion.