[关键词]
[摘要]
目的:了解原发性青光眼抗青光眼手术后使用降眼压滴眼液的眼表损伤。
方法:病例对照研究。研究对象在我院就诊并接受降眼压滴眼液并含有苯扎氯铵防腐剂的原发性青光眼(包括原发性闭角型青光眼与原发性开角型青光眼)患者。按照患者是否已接受抗青光眼手术,将患者分为未手术组与手术组,对眼表疾病(ocular surface disease, OSD)的检测指标进行比较。主要指标:泪膜破裂时间(tear film break-up time,TFBUT)、荧光素角膜染色(点状角膜炎)。
结果:本研究共有39例72眼原发性青光眼,其中手术组9例14眼,未手术组30例58眼,手术组与未手术组中OSD的比例分别为78%与67%,两组间差异无统计学意义。手术组TFBUT异常率50%以及点状角膜炎发生的比例14%与未手术组(分别为54%,5%)比较,均无统计学差异。
结论:原发性青光眼患者行抗青光眼术后,再接受降眼压滴眼液后的眼表损伤情况与未行手术而接受降眼压滴眼液者相近。
[Key word]
[Abstract]
AIM:To analyze ocular surface changes induced by topical intraocular-press(IOP)-lowering medication in primary glaucoma patients after antiglaucoma surgery.
METHODS:A case control study. Patients with primary glaucoma(primary angle-closure glaucoma and primary open angle glaucoma)who were treated by a topical IOP-lowering medication containing benzalkonium chloride(BAK)were enrolled. According to either accepted antiglaucoma surgery or not, patients were divided into group with surgery and group without surgery, indicators of ocular surface disease(OSD)were compared between the two groups. Main indicators for outcomes included tear film break-up time(TFBUT)and fluorescein staining of the cornea(punctate keratitis).
RESULTS:This study collected 39 primary glaucoma cases(72 eyes), in which there were 9 cases(14 eyes)in group with surgery and 30 cases(58 eyes)in group without surgery. There were 78% of the cases in group with surgery suffering from the OSD and 67% in group without surgery. There was no statistically significant difference between the two groups. In group with surgery, TFBUT abnormal rate was 50% and 14% of the cases with punctate keratitis. In group without surgery, the rates were 54% and 5% respectively, and there were no statistical differences between the two groups on the two indicators.
CONCLUSION:The probability of ocular surface damage in primary glaucoma patients with topical IOP-lowering medication to control IOP after antiglaucoma surgery is similar to that in primary glaucoma patients with topical IOP-lowering medication only.
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