Higher-Order Aberrations and Visual Acuity with Wavefront-Guided and Wavefront-Optimized Ablation in Laser Keratorefractive Surgery

PURPOSE: To compare higher-order aberrations (HOAs) and visual acuity after wavefront-guided and wavefront-optimized laser keratorefractive surgery. METHODS: This retrospective study consisted of consecutive cases of eyes that underwent wavefront-guided (VISX S4 CustomVue(R)) or wavefront-optimized (WaveLight(R) EX500) laser assisted in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK). Preoperative and postoperative uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), manifest refraction spherical equivalent (MRSE), and preoperative and 3 month postoperative HOAs were compared. RESULTS: There were no statistical differences in UCVA, BCVA, MRSE, or total HOAs in either the LASIK and PRK groups (all p > 0.05). Induced amount of spherical aberration (SA) was significantly lower in the wavefront-optimized LASIK and PRK than wavefront-guided LASIK and PRK. CONCLUSIONS: In laser keratorefractive surgery, wavefront-guided and wavefront-optimized platforms produced equivalent visual outcomes and no differences in total HOAs. However, the wavefront-optimized platform caused less spherical aberration 3 months after operation.

Accuracy of Ocular Biometry and Postoperative Refraction in Cataract Patients with AL-Scan(R)

PURPOSE: To compare the axial lengths, anterior chamber depths, and keratometric measurements and to predict postoperative refractions of AL-Scan(R), IOL master(R), and ultrasound. METHODS: A total of 40 eyes in 30 patients who received cataract surgery were included in the present study. The axial length, anterior chamber depth, and keratometry were measured by 2 types of partial coherence interferometry (AL-Scan(R) and IOL master(R)) and ultrasound. The SRK/T formula was used to calculate IOL power, and the predictive error which subtracts predictive refraction from postoperative refraction was compared among the ocular biometry devices. RESULTS: Axial lengths were 23.08 +/- 0.62 mm, 23.09 +/- 0.62 mm, and 22.99 +/- 0.62 mm measured by AL scan(R), IOL master(R), and ultrasound, respectively. Axial length measured by ultrasound was statistically significantly shorter than AL scan(R) and IOL master(R) (p < 0.001, p < 0.001, respectively). The anterior chamber depth and keratometry were 3.11 +/- 0.06 mm and 44.82 +/- 1.34 D measured by AL scan(R), and 3.13 +/- 0.06 mm and 44.85 +/- 1.26 D measured by IOL master(R), respectively. The differences of anterior chamber depth and keratometry between the 2 devices were not statistically significant (p = 0.226, p = 0.331, respectively). The mean absolute prediction errors were 0.44 +/- 0.35 D, 0.40 +/- 0.34 D, and 0.39 +/- 0.30 D in AL-Scan(R), IOL master(R) and ultrasound, respectively, and were not statistically significantly different (p = 0.843, p = 0.847, p = 1.000, respectively). CONCLUSIONS: The ocular biometric measurements and prediction of postoperative refraction using AL-Scan(R) were as accurate as IOL master(R) and ultrasound.

Visual and Optical Functions after Diffractive Multifocal Intraocular Lens

PURPOSE: To evaluate near, intermediate, and distant vision, optical quality, and patient satisfaction with Acri.LISA aspheric diffractive multifocal IOL. METHODS: Forty eyes of 20 patients received phacoemulsification and implantation of Acri.LISA IOL. Visual acuity was measured postoperatively at 1 week, 1 month, and 6 months. Contrast sensitivity, wavefront aberration, and visual function via questionnaire were measured at postoperative 1 month. RESULTS: Uncorrected near, intermediate, and distanct visual acuity at 1 month were 0.09 +/- 0.14, 0.29 +/- 0.17 and 0.11 +/- 0.12, respectively. At 6 months, similar visual acuity results were measured. Total and higher-order wavefront aberration values were 0.66 +/- 0.29 and 0.24 +/- 0.08, respectively. Photopic contrast sensitivity at 1.5, 3, 6, 12, and 18 cycles/degree were 1.38 +/- 0.32, 1.73 +/- 0.24, 1.75 +/- 0.21, 1.33 +/- 0.18, and 0.77 +/- 23, respectively, and mesopic contrast sensitivity values were 1.37 +/- 0.27, 1.72 +/- 0.16, 1.63 +/- 0.14, 1.01 +/- 0.19, and 0.50 +/- 0.22. Total subjective visual function score was 3,127 +/- 354, near work was 244 +/- 36, distance work was 256 +/- 21, and night driving was 221 +/- 42. CONCLUSIONS: The Acri.LISA 366D multifocal IOL can be effective for improving patient satisfaction after cataract surgery as well as for presbyopia correction.

The Effect of alpha1-Adrenergic Blocker on Phacoemulsification

PURPOSE: To evaluate the influence of alpha1-adrenergic blocker on phacoemulsification and the preventive effect of adrenergic blocker (AB) cessation before cataract surgery. METHODS: A prospective study was performed involving 92 eyes of 60 patients undergoing cataract surgery. Cases were divided into three groups: the use of alpha1AB with discontinuance before surgery (32 eyes), the use of alpha1AB with no discontinuance before surgery before surgery (31 eyes), and eyes not treated with alpha1AB (29 eyes). Clinical measurements and intraoperative parameters were compared among the three groups. RESULTS: Preoperative maximum pupil diameters of patients treated with alpha1AB were smaller than those of patients not administered alpha1AB (p = 0.027 and p = 0.018, respectively). The incidence of IFIS in the patients using of alpha1AB with discontinuance before surgery was 6.25%, and that in the patients using of alpha1AB with no discontinuance before surgery was 6.45%. There was no IFIS outbreak in the patients not using of alpha1AB. We noted no significant differences in absolute phaco time during phacoemulsification (p = 0.207) or in the three-month postoperative best corrected visual acuities among the three groups (p = 0.189). CONCLUSIONS: Importantly, there appears to be a significant correlation between alpha1AB and the development of IFIS. To prevent complications of IFIS, surgeons should be vigilant in identifying patients taking alpha1AB, checking the degree of preoperative pupil dilatation and anticipating intraoperative difficulties. In addition, appropriate modifications should be made to the surgical strategy. Furthermore there was no benefit to discontinuing alpha1AB treatment before cataract surgery in the prevention of IFIS.

Clinical Results of Crystalens(R) (AT-45) Accommodating Intraocular Lens

PURPOSE: To evaluate one-year clinical results of Crystalens(R) (AT-45, Eyeonics, CA, USA) accommodating IOL implantation. METHODS: In this retrospective study, 25 eyes of 18 patients had phacoemulsification and Crystalens(R) accommodating IOL implantation. Distance and near visual acuity (VA) during the 12-months were measured. RESULTS: At two months, uncorrected distance visual acuity (VA) of 13 eyes (52.0%) and 21 eyes (84.0%) were 20/25 and 20/40 or better, respectively. At six months, 11 eyes (44.0%) and 21 eyes (84.0%) were 20/25 and 20/40 or better, respectively. At 12 months, 11 eyes (44.0%) and 17 eyes (68.0%) were 20/25 and 20/40 or better, respectively. At two months, the uncorrected near VAs of 11 eyes (44.0%) and 17 eyes (68.0%) were 20/25 and 20/40 or better, respectively. At six months, 9 eyes (36.0%) and 16 eyes (64.0%) were 20/25 and 20/40 or better, respectively. After 12 months, 6 eyes (24.0%) and 16 eyes (64.0%) were 20/25 and 20/40 or better, respectively. CONCLUSIONS: The uncorrected near VAs gradually decreased with the passage of time until 12 months after Crystalens(R) accommodating IOL implantation.

Clinical Results of Crystalens(R) (AT-45) Accommodating Intraocular Lens

PURPOSE: To evaluate one-year clinical results of Crystalens(R) (AT-45, Eyeonics, CA, USA) accommodating IOL implantation. METHODS: In this retrospective study, 25 eyes of 18 patients had phacoemulsification and Crystalens(R) accommodating IOL implantation. Distance and near visual acuity (VA) during the 12-months were measured. RESULTS: At two months, uncorrected distance visual acuity (VA) of 13 eyes (52.0%) and 21 eyes (84.0%) were 20/25 and 20/40 or better, respectively. At six months, 11 eyes (44.0%) and 21 eyes (84.0%) were 20/25 and 20/40 or better, respectively. At 12 months, 11 eyes (44.0%) and 17 eyes (68.0%) were 20/25 and 20/40 or better, respectively. At two months, the uncorrected near VAs of 11 eyes (44.0%) and 17 eyes (68.0%) were 20/25 and 20/40 or better, respectively. At six months, 9 eyes (36.0%) and 16 eyes (64.0%) were 20/25 and 20/40 or better, respectively. After 12 months, 6 eyes (24.0%) and 16 eyes (64.0%) were 20/25 and 20/40 or better, respectively. CONCLUSIONS: The uncorrected near VAs gradually decreased with the passage of time until 12 months after Crystalens(R) accommodating IOL implantation.

Risk Factors of Intraocular Pressure (IOP) Changes in Pseudoexfoliation (PEX) Syndrome

PURPOSE: We evaluated the short and long-term changes of intraocular pressure (IOP) and studied its risk factors in pseudoexfoliation (PEX). METHODS: A total of 40 eyes that had been newly diagnosed with PEX from January 1, 1995 to December 31, 2007 were included in this study. Age, gender and accompanying systemic disease were recorded. In addition, the age, gender, number of antiglaucoma eye drops, history of cataract operation, and history of systemic disease were evaluated as risk factors for IOP elevation during the follow-up periods. Pre and post cataract operation IOP was checked to evaluate the effect of the cataract operation on IOP. RESULTS: The risk factors for IOP elevation in patients newly diagnosed with PEX were old age and female gender. After treatment, a long follow-up period and number of eyedrops were risk factors for IOP elevation. The cataract operation had a one year IOP control effect, especially in cases where the pre operative IOP was greater than 21 mmHg. Over the long term, however, the IOP control effect of cataract surgery could not be determined. CONCLUSIONS: IOP increased as result of increased patient age. Phacoemulsification was a protective factor for IOP elevation and may be a good method for short-term IOP control.

Influence of Lens Opacity on Nerve Fiber Layer Analysis in Glaucomatous and Normal Eyes

PURPOSE: To analyze the retinal nerve fiber layer in glaucoma eyes and in normal eyes, before and after cataract surgery using GDx (Laser Diagnostic Technologies, Inc., San Diego, CA, U.S.A), - a scanning laser polarimetry, and to evaluate the effect of lens opacity on retinal nerve fiber layer analysis. METHODS: Ocular examination and GDx analysis were performed one month before and after cataract surgery on 16 eyes of 10 patients affected with glaucoma and 14 normal eyes of 9 patients at St. Mary's Hospital. Regarding the eyes affected with glaucoma, only those who showed no evidence of glaucoma progression on a visual field examination before and after the cataract surgery were included, and every cataract surgery was performed perfectly. Comparisons of the GDx parameters before and after cataract surgery were performed using the Wincoxon signed rank test. RESULTS: All GDx parameters before and after cataract surgery in normal eyes showed no significant differences. In the glaucoma patients, differences in symmetry (p=0.047), superior ratio (p=0.007), ellipse modulation (p=0.001), and GDx number (p=0.008) were statistically significant. CONCLUSIONS: GDx is an examination based on the birefringent nature of retinal nerve fiber layer so the values can change according to changes in the cornea and lens, which are birefringent. This study compared the GDx parameters before and after cataract surgery of glaucoma patients and normal eyes. Our results showed that lens opacity has a minor and subtle effect on GDx parameters, and indicated the most sensitive parameters that reflect the change of retinal nerve fiber layer. Further studies should be performed using a larger sample with statistical support.

Factors Associated with Visual Outcomes of Postoperative Endophthalmitis Following Cataract Surgery

PURPOSE: The most serious complication related to cataract surgery is endophthalmitis. Although its incidence is decreasing, it remains the great threat to the outcome of visual acuity in patients who received cataract surgery. METHODS: Retrospective analysis was performed on 18 patients who were diagnosed with endophthalmitis. The following factors were investigated: method of cataract extraction, performance of anterior vitrectomy, presence of posterior capsule rupture, results of bacterial culture, existence of systemic disease, and the duration of time from initial cataract surgery to diagnosis of endophthalmitis and then to subsequent posterior vitrectomy. In addition, the differences in final visual acuity due to variations in these factors were analyzed. RESULTS: Patients who were diagnosed with endophthalmitis and had been commenced on systemic antibiotics within a week of the cataract operation, showed better outcomes in final visual acuity (P=0.043). CONCLUSION: Occurrence of endophthalmitis and subsequent usage of systemic antibiotics within a one-week time frame of cataract surgery, led to statistically significant improvement in final visual acuity compared to cases in which these events occurred one week later.

Factors Associated with Visual Outcomes of Postoperative Endophthalmitis Following Cataract Surgery

PURPOSE: The most serious complication related to cataract surgery is endophthalmitis. Although its incidence is decreasing, it remains the great threat to the outcome of visual acuity in patients who received cataract surgery. METHODS: Retrospective analysis was performed on 18 patients who were diagnosed with endophthalmitis. The following factors were investigated: method of cataract extraction, performance of anterior vitrectomy, presence of posterior capsule rupture, results of bacterial culture, existence of systemic disease, and the duration of time from initial cataract surgery to diagnosis of endophthalmitis and then to subsequent posterior vitrectomy. In addition, the differences in final visual acuity due to variations in these factors were analyzed. RESULTS: Patients who were diagnosed with endophthalmitis and had been commenced on systemic antibiotics within a week of the cataract operation, showed better outcomes in final visual acuity (P=0.043). CONCLUSION: Occurrence of endophthalmitis and subsequent usage of systemic antibiotics within a one-week time frame of cataract surgery, led to statistically significant improvement in final visual acuity compared to cases in which these events occurred one week later.

Comparison of Short-term Outcomes of Argon Laser versus Selective Laser Trabeculoplasty in Open-Angle Glaucoma

PURPOSE: To evaluate the pressure-lowering effects of selective trabeculoplasty versus these of Argon laser trabeculoplasty. METHODS: Fifteen eyes of 15 patients with primary open-angle glaucoma and ocular hypertension, all with IOPs over 30 mm Hg received SLT and 30 eyes of 30 patients with the same diagnosis were treated with ALT. Patients were evaluated after laser treatments at 1 hour, 1 day, 1 week, 1 month, and 3 months using slit lamp examinations and Goldmann applanation tonometry. RESULTS: At 3 months postoperative, the SLT group had a mean IOP of 16.9+/-4.2 mmHg with a mean reduction of 31.2+/-20.1%, while the ALT group had a mean IOP of 17.9+/-5.4 mmHg with a mean reduction of 26.3+/-23.3%. CONCLUSIONS: Selective trabeculoplasty and Argon laser trabeculoplasty are equally effective statistically in lowering IOP over a 3-month period (p=0.47). SLT has been shown to be safe and effective in lowering IOP.

Effects of Mitomycin C on Lens: in Vitro Study

PURPOSE: Cataract could occur as a complication of mitomycin C (MMC) used to increase the success rate of glaucoma surgery. Thus, the effects of MMC on cellular growth inhibition and apoptosis induction were examined by the culturing lens epithelial cells and the morphologic change in cells when MMC induced apoptosis. METHODS: Cellular morphology was observed after treating the mouse lens epithelial cell line, alpha-TN4, with MMC at different concentrations. Cellular toxicity was measured using LDH. Furthermore, IC50 inhibiting cellular proliferation and IC50 inducing apoptosis were measured. Staining and TUNEL assay were done to define apoptosis. The lens shape was observed under a transmission electron microscope, and electrophoresis was performed investigate the change in protein level when cataract was induced by MMC. RESULTS: The lens epithelial cells were atrophic even at low concentrations of MMC and more severe cellular changes along with reduced survival rate were seen at higher concentrations. According to the results of measuring cellular toxicity using LDH, the amount of LDH increased with increasing concentrations of MMC. The results of staining showed the findings of apoptosis of cells with orange-colored, compressed nuclei at low concentrations of MMC. Also on microscopic observation, the compression of chromosomes and fragmentation of nuclei were seen. Furthermore, the number of the high molecularr 53 KDa protein was increased among lens proteins of fertilized egg. CONCLUSIONS: These results demonstrated that MMC induced apoptosis of lens epithelial cells; the formation of cataract occurred in subcapsular area and the equator region; and denatuation of lens proteins and high molecular weight 53 KDa protein were increased.

3 Cases of Latanoprost Associated Herpes Simplex Keratitis

PURPOSE: To report three cases in which herpes simplex keratitis developed after initiation of latanoprost. METHODS: We experienced three patients with herpes simplex keratitis after latanoprost instillation, two patients with open angle glaucoma and one is congenital glaucoma. We preformed herpes simplex virus culture for two cases. RESULTS: One patient with history of herpes simplex keratitis, resolution when latanoprost was stopped; antiviral therapy could not eradicate herpes simplex keratitis until latanoprost was discontinued. The second patient with latanoprost associated herpes simplex keratitis cleared with discontinuation of latanoprost and start of antiviral therapy. The third patient had resolution, only when latanoprost was stopped. The result of viral cultures for two cases was negative. CONCLUSIONS: Clinicians should be aware of development or recurrence of herpes simplex keratitis when laranoprost is used for intraocular pressure control.

Comparison in Pain between Photorefractive Keratectomy and Laser In Situ Epithelial Keratomileusis during Intraoperative and Postoperative Period

PURPOSE: To compare the degree of pain between photorefractive keratectomy(PRK) and laser in situ epithelial keratomileusis(LASEK) during intraoperative and postoperative period, we used the visual pain analogue scale. METHODS: Forty patients requiring refractive surgery of both eyes were randomized into 2 groups and were studied by double-blind clinical trial prospectively. Each patient had PRK performed on one eye and LASEK on the other on the same day. On half of the patients PRK was performed before LASEK. The other half had LASEK first and then PRK. All surgeries were performed by one surgeon and subjective pain was assessed using analog scale of no pain(0) to worst pain imaginable(10) during the operation, post operatively, and on the first, second, sixth postoperative day. RESULTS: There were no significant carry-over effects in all 5 comparisons(p>0.30) between the two groups of different operation order. There was less discomfort in the PRK group compared with the LASEK group on all days of measurement. The pain felt by the patients was significantly less in the PRK group on the first(mean 3.29 versus 5.46, p<0.0001) and the second(mean 1.39 versus 3.61, p<0.0001) postoperative day. The sum of pain in all measuring days were also significantly less(mean 10.39 versus 16.29, p<0.0001) in the PRK group. CONCLUSION: We concluded that PRK is a more comfortable refractive surgery than LASEK in the aspect of pain.

Changes of Anterior Chamber Depth and Anterior Chamber Angle after Photorefractive Keratectomy

PURPOSE: To investigate the structural changes of anterior chamber after photorefractive keratectomy in myopic eyes, we assessed the changes of anterior chamber(AC) depth, angle and correlations with ablation depth at sixth postoperative month. METHODS: We performed photorefractive keratectomy on 77 eyes of 40 patients and divided them into 3 groups by the degree of preoperative myopia; less than -4.0 diopter, between -4.0 and -6.0 diopter and greater than -6.0 diopter. We assessed the changes of AC depth and angle using Scheimpflug camera(EAS-1000, Nidek, Japan) after 6 months. RESULTS: The average preoperative AC depth and angle were 3.59+/-0.27 mm, 44.20+/-2.58 and 3.53+/-0.27 mm, 43.29+/-1.65 at sixth postoperative month. The reductions in AC depth and AC angle were statistically significant(P0.05). The changes of both AC depth and AC angle were not affected by ablation depth(P>0.05). CONCLUSIONS: Structural changes of anterior chamber were significant 6 months after photorefractive keratectomy and the changes were not affected by degree of myopia nor by ablation depth.

Clinical Outcome of Minus Diopter Posterior Chamber Lens

PURPOSE: To evaluate the effectiveness of the minus diopter posterior chamber intraocular lens(PC IOL) implantation in highly myopic patients undergoing cataract extraction. METHODS: We have evaluated the outcome of 27 highly myopic patients(32 eyes) who had undergone extracapsular cataract extraction with minus diopter PC IOL implantation during the period from July 1995 to December 2000. RESULTS: At the time of the operation examined average axial length in the operated eyes was 31.8 mm and the average of calculated diopter of PC IOL was -2.45 diopter(D). There was no statistically significant difference between the preoperative and postoperative best corrected visual acuity in each inserted IOL diopter(p>0.05). The preoperative refraction ranged from -17D to 29D(-22.45D in average), and visual acuity improved by over 0.5 in 15 eyes(49.5%). After cataracts developed in 4 eyes(12.5%), requiring Nd-YAG laser posterior capsulotomy. There were no serious complications such as retinal detachment. CONCLUSION: It is suggested that PC IOL implantation after extracapsular cataract extraction in highly myopic eyes can improve the visual acuity, without in increased risk of after cataracts and complications such as retinal detachment.

Inhibitory Effect of Antibody to alphavbeta5 in Corneal Angiogenesis

PURPOSE: This study investigated the importance of alphavbeta5 function during vascular endothelial growth factor (VEGF) induced corneal angiogenesis by examining the effects of antibody to alphavbeta5 that blocks alphav 5-mediated cell adhesion to vitronectin. METHODS: A hydrogel disk containing 500 ng of VEGF was implanted into the superior corneal stroma of each of sixteen New Zealand white rabbit eyes. Each eye also received a second hydrogel disk placed adjacent to the first, randomized to contain either 40 g of antibody to alphavbeta5 (n=8) or phosphate-buffered saline (PBS)(n=8). Both disks were positioned 1.2 mm apart from the superior limbus. Eyes were examined daily under a stereomicroscope by two observers and assigned an angiogenesis score based on number and length of new blood vessels. RESULTS: On days 3 through 7 postimplantation, angiogenesis scores were significantly lower in eyes treated with antibody to alphavbeta5 (averaged score=16.33) as compared to eyes treated with PBS (averaged score=26.52)(P<0.05, Wilcoxon signed rank test). CONCLUSIONS: In a rabbit corneal micropocket assay, antibody to alphavbeta5 inhibits corneal angiogenesis induced by VEGF. Substances that target the integrin alphavbeta5 subunit may have therapeutic potential in disorders characterized by ocular neovascularization.

The Changes in the Area of the Anterior Capsulotomy Size

PURPOSE: To investigate whether there was any difference in anterior capsular opening area between the use of silicone intraocular lens(IOL) and acrylic IOL after continuous curvilinear capsulorhexis(CCC). METHODS: In 42 eyes, acrylic IOL(Acrysof(R), Alcon, U.S.A.) were inserted into the capsular bag during phacoemulsification, and in 36 eyes silicone IOL(Chiroflex II(R) , Chiron, U.S.A.) were inserted. The reduction rate of anterior capsular opening area at first, second, third and sixth postoperative month were compared between the two groups. RESULTS: On the whole, the reduction in anterior capsular opening area was larger by 0.574 mm 2 when silicone IOL was used, but the different was not statistically significant(P= .061). The result was the same at 1 month(P= .149), 2 months(P= .144), 3 months(P= .223), 6 months(P= .163) after surgery. CONCLUSIONS: We concluded that there was little difference in the changes of anterior capsular opening area after CCC between the use of silicone IOL and acylic IOL, and other factors should be considered.

A Factual Survey on PRK and LASIK in Korea

The surgeons performing photorefractive keratectomy[PRK]and laser in situ keratomileusis[LASIK]and patients got these relatively convenient and effective procedures for correcting myopia are increasing now. Korean Society of cataract and refractive surgery[KSCRS]performed a survey on PRK and LASIK with the members of this society. Seventy-six members replied to questionnaire and fifty answered that they were doing PRK or LASIK. The number of surgeons who had performed more than three hundred cases of PRK or LASIK were twenty-four and seventeen, respectively. The number of surgeons who having done these procedures less than three years were twenty-five and this suggested these operations were much increased recently. Maximum attempted corrections were -5.9 to -6.5 diopter in PRK and -14.4 to -14.9 diopter in LASIK. The surgeons thought reduction of best corrected visual acuity as the complication of LASIK procedure was occurred the incidence of 3.97%[0.1~30%]. Eighty percent of members replied they explained the predictable result and possible complication of operation to their patients by themselves and seventy seven percent of members agreed to the plan that surgeons should do PRK and LASIK with qualification from Korean Ophthalmological Society. We suggest this survey could help performing better procedure by establishing common therapeutic criteria with communication of information and opinion between ophthal-mologist.

Adverse Effect of Topical Antiglaucoma Medication Conjunctival Cell Profile and Outcome of Filtration Surgery

We assessed quantitatively conjunctival biopsy specimens from 48 primary open angle glaucoma patients[62 eyes]undergoing filtration surgery by light microscopy. The patients were subdivided depending on age, sex, and their therapeutic regimen and duration before surgery. With age, there was a significant increase in lymphocytes and macrophages within the substantia propria of conjunctiva[p<0.05]. The longer the total treatment duration with topical antiglaucoma medication was, the higher the number of lymphocytes and macrophages were[p<0.05]. Whereas, when the treatment duration was adjusted, there was no significant difference between the single therapeutic regimen group and the multiple regimen group. There were some differences in the number of fibroblasts, lymphocytes and macrophages between the group that needed postoperative-antiglaucoma medication[surgical failure group]and the group without postoperative-antiglaucoma medication[surgical success group]but there were no statistically significant differences. In conclusion, administration of topical medication induced a significant degree of subclinical inflammation and change of conjunctival cell profile. However it did not depend on multiple drug regimen but on total treatment duration.