药源性角膜病变26例临床分析

Clinical analysis of drug-induced corneal lesions:a report of 26 cases

目的分析10年临床局部应用抗生素滴眼剂、抗病毒滴眼剂以及激素滴眼剂对眼表的毒性作用,以及药源性角膜病变的临床特征、治疗效果。方法对26例35眼滴眼剂诱发的药源性角膜病变的临床资料进行回顾性分析。结果 26例患者35眼均于滴眼液点眼1周后,临床表现为眼部刺激症状(异物感、流泪、畏光、视力下降);检查发现点状角膜糜烂17例,弥漫性角膜上皮混浊16例,角膜基质浸润2例。其中合并有糖尿病病史者5例,眼表及内眼手术后18例,眼部炎症9例,全身状况良好者3例。停药后,眼部症状缓解、消退。结论临床医生应注意各种滴眼剂对角膜的毒性作用,并积极预防和治疗,规范用药。

Objective To analyze the drug toxicity of eye drops in ocular surface, to investigate the clinical features of drug-induced corneal lesions and evaluate the efficiency of the treatment. Methods The clinical data of 26 cases （35 eyes） of drug-induced corneal lesions were retrospectively analyzed. Results Eye drops were used in all the 26 patients （35 eyes） for more than 1 week. The clinical manifestations were eye irritation, eye wear, tearing, photophobia, and decreased vision, and the signs were ocular ciliary hyperemia and punctate corneal erosion in 17 eyes, diffuse corneal opacity in 16 eyes, and comeal stromal infiltration in 2 eyes. There were 5 patients with a history of diabetes mellitus, 18 cases of eye surgery, 9 cases of ophthalmitis, and 3 patients with good body condition. After drug withdraw, the eye symptoms relieved and disappeared. Conclusions Clinicians should pay more attention to the toxicity of all eye drops on cornea, and actively prevent and control the drug-induced corneal lesions.