长期使用青光眼药物对眼表的影响  

Effects of long-term topical antiglaucoma treatment on ocular surface

作　　者：刘杏[1] 毛真[1] 钟毅敏[1] 黄晶晶[1] 王涛[1] 肖辉[1] 李媚[1] 

机构地区：[1]中山大学中山眼科中心,中山大学眼科学国家重点实验室,广州510060

出　　处：《中国实用眼科杂志》2009年第4期332-335,共4页Chinese Journal of Practical Ophthalmology

基　　金：广东省科技计划项目（编号2007A060305009）

摘　　要：目的探讨长期使用青光眼药物对患者眼表的影响。方法收集局部使用青光眼药物3个月以上的患者65例108只眼，分为单种药物使用组（A组）和多种药物使用组（B组）；另收集正常对照组（C组）25例25只眼。对所有观察对象进行泪膜破裂时间测定（BUT）、基础泪液分泌试验（ST）、角膜上皮荧光素染色、结膜上皮虎红染色以及结膜印迹细胞（IC）检查。结果正常对照组BUT（12．25±5．40）s，ST（11．65±4．66）mm，A组BUT（6．97±4．87）S，ST（7．19±5．36）mm，明显低于正常对照组（BUTP=0．000；STP=0．001）。B组BUT（4．81±2．45）S，显著短于正常对照组（P=0．000）和A组（P-0．008）；ST（5．20±2．97）mm，显著少于正常对照组（P=0．000）和A组（P=0．026）。A组和B组的角膜荧光素染色评分和结膜虎红染色评分显著高于正常对照组。与正常对照组相比，A组和B组IC评分2—3级所占比例明显增高，结膜上皮表现出鳞状上皮化趋势。结论长期使用青光眼药物会导致患者泪膜稳定性下降、泪液分泌减少，角膜上皮荧光素染色增多，结膜上皮杯状细胞减少、上皮细胞呈鳞状上皮化等泪膜、角膜和结膜的损伤。Objective To determine the effects of long-term antiglaucoma topical medication on the ocular surface in glaucoma patients.Methods This study included 108 eyes from 65 patients treated with topical antiglaucoma medication for at least 3 months, and 25 eyes from 25 healthy subjects served as the control group.Routine ophthalmic examinations and tests to evaluate tear fluid and ocular surface were performed in all subjects,including tear break-up time, Schirmer test,corneal fluorescein staining,conjunctival rose bengal staining, and conjunctival impression cytology test.Results Compared with the normal control,tear break-up time and tear secretion were significantly decreased in patients treated with antiglaucoma medication over the long term,especially in those treated with multiple antiglaucoma drugs.Increased corneal fluorescein staining and conjunctival rose bengal staining were observed.The conjunctival impression cytology scores were significantly higher in the treated patients.Conclusions Long-term use of antiglaucoma medication could induce tear film function change,corneal damage and conjunctival epithelium damage.Multiple antiglaucoma eyedrops treatment may cause more severe adverse effects on the ocular surface.

关 键 词：青光眼 青光眼药物 防腐剂 眼表 

分 类 号：R988.1[医药卫生—药品] R777.1[医药卫生—药学]