局部药物中不同防腐剂对青光眼患者干眼的影响差异

Effects of different preservatives in topical medications on glaucoma patients with dry eye

目的探讨苯扎氯胺(BAK)和Polyquad作为局部药物防腐剂对导致青光眼患者干眼不良影响的差异。方法回顾分析29例(29眼)长期使用BAK防腐剂局部药物后出现干眼的青光眼患者临床资料。用以Polyquad为防腐剂的局部青光眼药物替换原有药物治疗,于更换药物治疗方案前及其后1个月和2个月分别对患者进行眼表疾病指数评分、泪液分泌试验、泪膜破裂时间及泪河高度等检查。结果更换局部药物前,患者眼表疾病指数评分为24.35±6.14,更换局部药物2个月时显著降低至13.90±3.12;同时泪河高度和泪膜破裂时间也分别由(0.18±0.06)mm和(5.29±2.09)s增加至(0.23±0.08)mm和(8.11±3.25)s,差异具有统计学意义(P<0.05)。结论使用以Polyquad为防腐剂的局部青光眼药物替换以BAK为防腐剂的药物,可能减轻药物对眼表的损害。

Objective To investigate the adverse effects of benzalkoniumchloride （BAK）-preserved and polyquad-preserved topical medications on glaucoma patients with dry eye. Methods Clinical records of 29 eyes from 29 patients who suffered from dry eye after long-term topical glaucoma medication therapy were reviewed retrospectively. BAK-preserved topical medication was replaced by polyquad-preserved one for 2 months. The ocular surface disease index （OSDI）, Schirmer I test, tear meniscus height and tear film break-up time （BUT） were measured at baseline, month 1 and month 2. Results The OSDI score decreased from 24.35 ± 6.14 to 13.90±3.12 at month 2 （P 〈 0.05 ）. The tear meniscus height was （0. 18 ± 0.06） mm at baseline and （0.23± 0.08 ） mm at month 2, while the BUT was （5.29 ± 2.09） s and （ 8.11 ± 3.25 ） s （ P 〈 0.05 ） respectively. Condusions Polyquad-preserved topical medication may reduce the ocular surface side effects of glaucoma patients as a replacement for BAK-preserved medication. （ Chin J Ophthalmol and Otorhinolaryngo1,2016 ,16 ：402-405 ）