眼局部用药所致干眼的诊断和治疗  

The diagnosis and treatment for dry eye induced by topical ophthalmic medications

作　　者：徐智勇[1] 张孝明[1] 赵敏[2] 

机构地区：[1]重庆医科大学附属第二医院眼屈光中心,重庆400010 [2]重庆医科大学附属第一医院眼科

出　　处：《中国实用眼科杂志》2007年第11期1205-1207,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的探讨眼局部用药所致干眼的诊断和治疗。方法对门诊有明确眼局部用药并有干眼症状37例54眼,就诊前既往诊断、眼局部用药情况、治疗前后基础Schirmer、BUT试验和荧光素染色的变化情况进行分析;根据病情给予停用原来的眼药,辅以不含防腐剂的人工泪液（爱丽眼液）和促眼表上皮修复药物（bFGF、EGF）。结果本组病例就诊前眼病诊断主要为慢性结膜炎17眼（31.48%）、病毒性结膜炎9眼（16.67%）、病毒性角膜炎7眼（12.96%）、沙眼5眼（9.23%）、近视滴用保健眼液4眼（7.41%）、青光眼6眼（11.11%）诊断不明确4眼（7.41%）等。既往眼局部用药有氯霉素、无环鸟苷、复方妥布霉素、噻吗洛尔、酮咯酸、地塞米松、萘甲唑林。分别对治疗前和治疗后的基础泪液分泌、BUT进行比较,差异有显著性（P〈0.01）。结论眼科局部用药不当易诱发药物性干眼的产生,应引起足够重视。Objective To discuss the diagnosis and treatment of dry eye induced by topical ophthalmic medications. Methods There are 37 （54 eyes）examples of dry eye symptom and the exactly the local application in clinical service,every example recorded underlying （primary） diagnoses,and inaccuracy of referring ophthalmologists＇ diagnoses、topical ophthalmic medications application information、prior and post treatment basic Schirmer、BUT（tear break-up time） experiment 、fluorescein staining and analysised the condition of change; all of the patient stoped using virgin ophthalmic remedy and gived the artificial tears （eg.hyaluronic acid） not containing antiseptic and the medicine of ocular surface epithelium repairing（bFGF、EGF）. Result The pre-diagnose oculopathy included chronic conjunctivitis 17 eyes（31.48%）,viral conjunctivitis 9（16.67%）,viral keratitis 7（12.96%）,trachoma 5（9.23%）,the myopia with topical eye drops to care for eyes＇ health 4 （7.41%）,glaucoma 6（11.11%）,diagnosis unknown 4（7.41%）eyes. The medicineused by those patients included chloromycetin、acyclovir、tobramycin compounded medication、timolol、ketorolac、dexamethasone 、 naphazoline and so on. We compared the basic lacrimal secretion and BUT between prior treatment and post treatment,found that the difference is significantly（P〈0.01）.Conclusion The abuse and confusion of topical ophthalmic medications is very easy to induce dry eye,we should play an emphasis on it to diagnose and cure correctly.

关 键 词：干眼 药物性 

分 类 号：R276.722.1[医药卫生—中医五官科学]