药物源性角膜病变30例临床分析  

Clinical analysis of 30 cases with drug induced keratopathy

作　　者：李炜炜[1] 孙旭光[1] 李然[1] 王智群[1] 刘畅[1] 

机构地区：[1]首都医科大学附属北京同仁医院北京同仁眼科中心北京市眼科学与视觉科学重点实验室北京市眼科研究所,100005

出　　处：《眼科》2010年第2期119-121,共3页Ophthalmology in China

摘　　要：目的探讨药物源性角膜病变的临床特征及治疗效果。设计回顾性病例系列。研究对象30例药物源性角膜病变患者。方法对患者的用药种类、给药方式,角膜上皮及基质病变情况、治疗方法及治疗效果等临床资料进行回顾性分析。主要指标用药史,临床表现,治疗方法 ,治疗效果。结果 30例患者中,17例有眼部疾病史;22例有频点抗菌药、抗病毒药、糖皮质激素或非甾体类抗炎药等滴眼液史;使用抗菌药进行连续眼表冲洗2例;连续性局部注射抗菌药、抗病毒药或糖皮质激素10例;频点抗阿米巴药物1例;频点表面麻醉药1例。临床表现为弥漫角膜上皮混浊8例,角膜基质浸润11例,角膜基质溃疡11例,伴有前房积脓3例。治疗方法主要采用停用既往药物,使用促进角膜修复的药物,治疗疗程为1周至4个月。治疗后角膜上皮愈合,基质浸润吸收,溃疡愈合形成斑翳,前房积脓完全吸收。结论药物源性角膜病变多与临床不合理使用药物有关,临床表现多样且无典型性,停用既往药物,促进角膜修复治疗有效。Objective To investigate the clinical features, treatment, and prognosis of drug-induced keratopathy. Design Retro- spective case series. Participants 30 patients with drug-induced keratopathy. Methods Clinical data of 30 cases with drug-induced keratopathy were analyzed, including the categories of induced-drugs, methods of administration, characteristics of keratopathy, treat- ment,and therapeutic effect. Main Outcome Measures History, clinical features, type of treatment, and prognosis of keratopathy. Results Among the 30 cases, 17 cases had the history of ocular diseases. Eye drops had been frequently used in 22 cases, including antiviral agents, corticosteroids, antibiotics, NSAID, anesthetics and amebicides. Prolonged lavage had been used in 2 cases. Subconjuctival injection, peribulbar injection or retrobulbar injection had been applied in 10 cases. Superficial punctuate keratitis, stromal infiltration, and stromal ulceration was found in 8, 11 and 11 cases, respectively. Hypopyon occurred in 3 cases. The treatment includes with-drawing the drugs that induced the keratopathy, and using the drugs to promote cornea healing. After being treated from 1 week to 4 months, the corneal epithelium and ulcer were healed, the infiltration in the stromal layer was cleared with scarring, and the hypopyon was subsided. Conclusion Drug induced keratopathy is associated with abuse of drugs. The clinical signs of this disease are usually nonspecific. The effective treatment includes withdrawing the drugs that induced keratopathy, and using the drugs that improve cornea healing. （Ophthalmol CHN, 2010, 19： 119-121）

关 键 词：角膜病变 药物 毒性 

分 类 号：R772[医药卫生—眼科]