Methods and apparatus are provided that prevent or inhibit functional regression caused by the stromal remodeling resulting from epithelial or fibroblastic apoptosis or necrosis in patients who will undergo or have undergone a thermal ciliary muscle tendinoplasty or scleral collagen shrinkage procedures. Methods and compositions are provided that prevent apoptosis in epithelial cells by stromal cooling during thermal tendinoplasty procedures; that create or restore stabilizing molecular cross-links between scleral stromal lamellar fibers; and that interrupt at least one step in the stromal remodeling response including inhibition of apoptosis, fibroblastic proliferation and migration, and inhibition of collagenesis.