To compare the conjunctival epithelial cell expressions of in flammatory cytok ines in normal subjects and in glaucoma patients treated over the long term. Cas e-control study. A total of 69 glaucoma patients treated over the long term and 15 normal subjects with no ocular abnormality or topical treatment. Amongst the 69 glaucoma patients, 27 were treated with preserved β-blockers, 24 with unpr eserved 0.5%timolol, and the other 18 patients with an association of < 2 prese rved drugs. All patients were treated for more than 1 year with the same treatme nt, with no significant differences between groups for mean ages and durations o f treatment at the time of the study. Impression cytology specimens were taken a nd processed for immunofluorescence techniques. Conjunctival cell expressionsof HLA DR, as a standard for inflammatory level, and the interleukins IL-6, IL-8, and IL-10 were obtained and quantified using flow cytometry. Immune markers an d proinflammatory cytokines in impression cytology specimens. We found a signifi cantly increased expression of all immunoinflammatory markers and mediators in t he conjunctival epithelium of glaucoma patients compared with normal eyes. Human leukocyte antigen DR was significantly higher in the 2 groups receiving preserv ed drugs than in the unpreserved timolol group. The 3 interleukins were similarl y overexpressed in all glaucoma groups, with no significant between-groups diff erences except for the expression level of IL-8, which was significantly higher in the multitreatment group than in the preservative-free one. The present stu dy confirms the increased expression of immunoinflammatorymarkers by the conjunc tival epithelium of glaucoma patients treated over the long term. The developmen t of nontoxic preservatives or preservative-free solutions is therefore of grea t interest.
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