白内障术后局部滴眼诱发药源性角膜病变的临床研究

Local eye drops after cataract surgery-induced drug-induced corneal lesion

目的:分析白内障术后滴妥布霉素地塞米松滴眼液对眼表的毒性作用,探讨妥布霉素地塞米松滴眼液所致药源性角膜病变的临床特征、治疗效果。方法:对临床所见的14例18眼白内障术后滴妥布霉素地塞米松滴眼液诱发的药源性角膜病变的临床资料进行回顾性分析。结果:患者14例18眼,均于白内障超声乳化术后使用妥布霉素地塞米松滴眼液点眼≥1wk;临床表现:眼部刺激症状:眼磨、流泪、畏光、视力下降。体征:眼部睫状充血,点状角膜糜烂11眼,弥漫性角膜上皮混浊6眼,角膜基质浸润1眼。其中合并有糖尿病病史者5眼,抗青光眼术后者6眼,玻璃体切除术后2眼,全身状况良好者5眼,停药后,眼部症状缓解、消失。结论:临床医生应关注妥布霉素地塞米松滴眼液对角膜的毒性作用,并积极预防和治疗,规范用药。

·AIM：To analyze the drug toxicity of tobramycin dexamethasone eye drops in ocular surface and to investigate the clinical features,treatment effect of dexamethasone-induced drug-induced corneal lesions.·METHODS：The clinical findings in 14 cases 18 eyes with tobramycin dexamethasone-induced drug-induced corneal lesions after cataract surgery were retrospectively analyzed.·RESULTS：Tobramycin dexamethasone eye drops were used in 14 patients 18 eyes for more than 1 week;clinical manifestations：eye irritation：eye wear,tearing,photophobia,decreased vision.Signs：ocular ciliary hyperemia and punctate corneal erosion in 11 eyes,diffuse corneal opacity in 6 eyes,corneal stromal infiltration in 1 eye.Patients with a history of diabetes mellitus in 5 eyes,anti-glaucoma surgery in 6 eyes,2 eyes after vitrectomy,the body in good condition in 5 eyes,after drug withdrawl,eye symptoms relieved,disappeared.·CONCLUSION：Clinicians should pay attention to the toxity of tobramycin dexamethasone eye drops on cornea,and prevention and treatment,standard medication should be performed.·