抗青光眼药物长期使用对眼表的影响

Effects of Long-term Use of Anti-glaucoma Drugs on the Ocular Surface

目的：研究长期使用青光眼药物对患者眼表结构的影响,为正确选择青光眼治疗药物提供依据。方法：将采用青光眼药物治疗≥3个月的青光眼患者40例（62只眼）设为病例组,以同期健康志愿者30例（30只眼）设为对照组,比较两组基础泪液分泌长度（ST）、泪膜破裂时间（BUT）、角膜荧光染色评分（FB）及结膜印记细胞评级（IC）。结果：病例组ST、BUT分别为（6.12±3.63）mm、（5.21±2.13）s,均短于对照组的（10.72±4.62）mm、（11.45±5.12）s（P〈0.01）;病例组FB评分为（2.19±0.42）分,高于对照组（0.62±0.04）分（P〈0.01）;病例组IC评级为Ⅱ-Ⅲ级比例为54.84%,高于对照组的5.00%（P〈0.01）。结论：青光眼患者长期使用青光眼药物会导致泪液分泌减少,泪膜稳定性下降,并加快结膜细胞鳞状上皮化进程,对泪膜、角膜及结膜均有损伤,应引起重视。

Objective： To study the effect of long-term use of anti-glaucoma drugs on the oculofacial structure of patients with glaucoma ocular, so as to provide evidence for the right choice of glaucoma treatment. Methods： 40 patients （62 eyes ）with glaucoma who were treated with anti-glaucoma drugs for 3 months were selected as the patients group, and another 30 healthy volunteers （30 eyes ） were chosen to be the control group. Then the Schirmer length（ST）, tear film break-up time （BUT）, conjunctival epithelium bengal staining score（RB）, corneal fluorescein staining score （FB） and conjunctival impression cell Rating（IC） were observed and compared between the two groups. Results： In the patients group, the ST was （6.12± 3.63） mm and the BUT was （5.21± 2.13） s which was shorter than （10.72± 4.62） mm and （11.45± 5.12） s in the control group, respectively （P〈0.01）. The FB score was （2.19± 0.42） in patients group, which was higher than （0.62± 0.04） in the control group （P〈0.01）. The IC rating results showed there was 54.84% at level II -III in the patients group, higher than that in control group （5.00%） （P〈0.01）. Conclusion： The long-term use of anti-glaucoma drugs for patients with glaucoma could reduce the tear secretion, decrease tear film stability, and speed up the cornea and conjunctiva squamous cell epithelization process. It could be injury to tear film, cornea and conjunctiva, thus we should take serious consideration to it.