Evaluation of Macular Thickness in Glaucoma Patients Using Prostaglandin Analog Eye Drops Undergoing Trabeculectomy with Mitomycin C: Prospective, Comparative, Randomized, Masked Examiner Study.

INTRODUCTION: The aim of the study was to evaluate the macular thickness of glaucomatous patients undergoing trabeculectomy (TREC) with mitomycin C (MMC) with or without the use of prostaglandin analog (PA) eye drops. METHODS: In this prospective, comparative clinical trial, patients with glaucoma and indications for TREC with MMC using PA and without previous macular changes were randomized into 2 groups: the study group (SG) and the control group (CG). In the CG, PA was suspended between 30 and 60 days after the preoperative exams. The subjects were evaluated, including optical coherence tomography (OCT) with the Cirrus 4000 macular protocol preoperatively and in the postoperative period on 3 occasions: 1-3 days ("PO1"), 6-9 days ("PO7"), and 27-30 days ("PO30") after surgery. The results were compared between groups. RESULTS: Thirty-five eyes of 35 patients were included (17 in the CG and 18 in the SG). There was no statistically significant difference in age (p = 0.2), the preoperative visual field mean deviation (p = 0.08), or the preoperative intraocular pressure (SG: 24.8 ± 7.8 mm Hg vs. CG: 22.8 ± 6.0 mm Hg, p = 0.4). The preoperative macular OCT parameters were equivalent between the groups (p > 0.05). When comparing the variation of parameters between the groups between preop and PO30 there was equivalence in all of the comparisons evaluated. The presence (or absence) of the lens did not affect the results. CONCLUSION: PA eye drops did not affect macular thickness after TREC with MMC in glaucomatous patients.

Optical microscopy study of human sclera stored in different media.

PURPOSE: To describe microscopic changes in the structure of human sclera immediately after enucleation (negative control group) and to compare them after being stored for three months in four different media: pure glycerin, absolute alcohol, benzalkonium chloride diluted in absolute alcohol (1:5000), and benzalkonium chloride diluted in balanced salt solution (1:5000). The comparison took into consideration their final state of conservation. DESIGN: Experimental study, laboratory investigation. METHODS: Optical microscopy was used to study the specimens after they had been in storage for one, two, and three months. The scleral fragments were prepared in thin plates, dyed, and then submitted to histologic analysis by two masked specialists. Unpreserved scleral fragments obtained right after enucleation were assessed and served as negative controls. RESULTS: The collagen fibers of scleras stored in glycerin presented with a more regular pattern, closer in appearance to the negative control group. Scleras stored in the other three media presented contorted collagen fibers. CONCLUSIONS: Our findings suggest that glycerin is close to being the ideal storage medium for sclera, because it maintains the structural characteristics of the collagen fibers. Research is ongoing to determine how to increase the bactericidal and antiviral properties of glycerin storage.