| Summary: | <b>Background:</b> Long-term use of antiglaucoma drugs induces adverse changes on the conjunctival surface. <b> Aim:</b> To evaluate the cytological changes in the conjunctival scrape smears of patients receiving long-term antiglaucoma medication and their histopathological correlation. <b> Materials and Methods:</b> Conjunctival scrape smears were taken from the eyes of patients on long-term antiglaucoma therapy for over three months (<i>n</i> = 75), patients taking antiglaucoma medication for less than three months (<i>n</i> = 100) and from glaucomatous patients in whom trabeculectomy was done as a primary procedure. Inflammatory cell counts, fibroblasts, and the degree of metaplasia were then evaluated both cytologically and histologically. The <i>t</i>-test was used to determine the predictive values of these parameters for the surgical outcome of trabeculectomies. <b> Results:</b> Long-term use of antiglaucoma therapy leads to a higher stage of metaplasia with an increase in the number of fibroblasts, subepithelial collagen deposition, and inflammatory infiltrate within the substantia propria of the conjunctiva. <b> Conclusions:</b> Long-term antiglaucoma medications induce a significant degree of metaplasia in the conjunctival surface that adversely affects the outcome of filtration surgery.
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