Drawbacks of glaucoma medical therapy need attentive consideration

BASSANO DEL GRAPPA, Italy — The side effects and drawbacks of long-term medical therapy in glaucoma patients should be more carefully considered by specialists, according to a panel of surgeons speaking at a meeting here.

Stefano Gandolfi, MD, OSN Europe Edition Editorial Board Member, said that the attitude of treating early, always and indistinctively should be critically re-examined.

"Glaucoma therapy can heavily affect life quality," he said at an ophthalmology meeting organized at the San Bassiano Hospital. "Medications, prostaglandins in particular, may add severe complications to the natural course of the disease. They stimulate inflammation that doesn't stop at conjunctival level but also extends to the trabecular meshwork."

In addition, medications may negatively affect the success of surgery when needed at a later stage of the disease.

"The Collaborative Initial Glaucoma Treatment Study has shown a significantly higher surgical success rate in eyes non-previously treated with medications," he said.

Other surgeons in the panel reported a high incidence of postoperative filtration failure from subconjunctival fibrosis in eyes previously treated with medication, particularly because prostaglandin analogues have become first-line treatment.

Disclosure: Dr. Gandolfi has no direct financial interest in the products discussed in this article, nor is he a paid consultant for any companies mentioned.