局部抗青光眼药物中苯扎氯胺导致干眼症的研究进展

Recent understandings of benzalkonium in anti-glaucoma drugs lead to dry eye disease

在长期接受局部抗青光眼药物治疗的患者中部分发生不同程度的干眼表现,其中抗青光眼药物中的防腐剂尤其是苯扎氯胺对其发生起主要作用。苯扎氯胺造成干眼的主要机制为:直接作用于泪膜,造成泪膜稳定性破坏导致泪液蒸发增加、泪膜渗透压增高;对角膜上皮细胞、结膜杯状细胞、睑板腺细胞等有细胞毒性作用,影响了泪膜黏液和脂质的分泌;通过免疫炎症反应造成眼表慢性炎症。本文通过探讨苯扎氯胺可能造成干眼的机制,希望为指导青光眼用药、开发新的眼部用药防腐剂体系等提供新思路。

A large part of glaucoma patients who have been treated with topical anti-glaucoma drugs for a period have experienced dry eye of varying degrees.Preservatives in anti-glaucoma drugs,particularly benzalkonium chloride(BAK),are believed to play a major role in the development of dry eye in patients.Based on existing research,this paper summarizes several main mechanisms of benzalamine causing dry eye.BAK can directly acts on tear film and destroy tear film stability,resulting in tear evaporation increasing and tear film osmolarity elevating.BAK has cytotoxic effects on corneal epithelial cells,conjunctival goblet cells and meibomian gland cells,thus can affect the secretion of mucus and lipid in tear film.BAK can also cause chronic inflammation of the eye surface,leading to discomfort in patients.By exploring the mechanism of BAK causing dry eye,we hope to provide ideas for guiding the use of glaucoma and developing a new antiseptic system for eyedrops.