正确认识滴眼液中的防腐剂

A correct understanding of preservatives in eye drops

滴眼液是眼科最主要的治疗制剂.多剂量的滴眼液中通常需要加入防腐剂,用以抑制病原微生物的生长和增加药物的稳定性.滴眼液使用不当可导致眼表损伤,甚至引起严重的视功能障碍,而滴眼液中所含有的防腐剂是导致这些损伤的最主要原因.最大限度避免或减少滴眼液对眼表的损伤已引起临床高度重视.然而,过分夸大防腐剂的危害也是目前需要正视的问题.正确认识滴眼液中的防腐剂,不仅可以避免其毒副作用,而且可综合考虑患者的眼病性质、眼表泪液状态、经济与文化背景、用药的方便程度及其成本与效益等多种因素,优选滴眼液,合理用药,最优利用防腐剂的优势.制定含防腐剂滴眼液的临床使用规范、广泛开展继续教育及开发理想的防腐剂,是此领域未来的发展方向.

Eye drops are the most commonly used preparations in ophthalmology.Preservatives are usually added in order to protect eye drops against pathogenic organisms and increase the solubility of the drugs in multi-dose containers.Ophthalmologists have paid a lot of attention to the preservatives in eye drops because they remain one of the main reasons for ocular surface damage,and even may lead to serious visual impairment in patients with inappropriate use of eye drops.However,it should be noted that the dangers of preservatives become overstated nowadays.It is necessary to completely evaluate the effects of preservatives in ophthalmic preparations,so that ophthalmologists can guide patients to correctly select eye drops containing preservatives and avoid dangerous side effects,according to their eye disease situation,state of tear function and ocular surface changes,cultural background and financial income,cost and benefit and convenience of the use of drugs,and other factors.The direction of the future development in this field is to establish the clinical guideline for use of eye drops containing preservatives,carry out continuing education courses on preservatives and develop ideal preservatives.