曲伏前列素滴眼液抗青光眼治疗中对眼表影响的观察

目的：探讨局部应用抗青光眼药物曲伏前列素滴眼液对患者泪膜功能的影响。方法：选取原发性开角型青光眼或高眼压患者18例32眼。患者均局部用曲伏前列素滴眼液，每晚滴1次。用药前及用药后1，2，3mo行症状评分及基础泪液分泌量测定（Schirmer Ⅰ test ，SⅠt）、角膜荧光素染色（corneal fluorescein staining，FL）、泪膜破裂时间（tear break-up time， BUT）。结果：全部患者用药前患者症状评分、FL的平均值为1.34±1.56，0.44±0.73，用药后1，2，3mo分别为2.75±1.63，1.08±0.84； 5.10±1.68，1.53±0.67； 6.33±1.40，1.98±0.50。用药后1，2，3mo患者症状评分、FL均显著高于用药前（P=0.00），且逐渐增加。全部患者用药前患者症状BUT，SⅠt的平均值为（7.76±0.92s），（8.47±2.73mm/5min），用药后1，2，3mo分别（7.08±1.15s），（7.73±3.44mm/5min）；（5.59±1.33s），（6.82±3.05mm/5min）；（4.29±1.87s），（6.04±3.15mm/5min）。用药后1，2，3mo患者BUT 值和SⅠt值均显著低于用药前水平（P=0.00），且逐渐减低。结论：短期使用曲伏前列素滴眼液即加重患者角膜刺激症状，泪膜稳定性下降， 泪液分泌减少。

Clinical study of adverse effects induced by Travoprost eyedrops on ocular surface

AIM： To evaluate the effects induced by topical antiglaucomatous drugs, Travoprost eyedrops on tear film. METHODS： Eighteen patients（32 eyes）with primary open-angle glaucoma or ocular hypertension were all treated with Travoprost eyedrops once every night. The symptom score, Schirmer＇s test（SⅠt）, corneal fluorescein staining（FL）, tear film break-up time（BUT）, were observed before the treatment and 1, 2 and 3mo after the treatment. RESULTS： The average symptom score, FL of all patients were 1.34±1.56 and 0.44±0.73 before the treatment, and 2.75±1.63, 1.08±0.84; 5.10±1.68, 1.53±0.67; 6.33±1.40, 1.98±0.50 respectively after 1, 2 and 3mo of the treatment. There was significant increase in symptom score and FL after the treatment for 1, 2 and 3mo（P=0.00）. The average BUT, SⅠt of all patients were（7.76±0.92s）,（8.47±2.73mm/5min）before the treatment, and（7.08±1.15s）,（7.73±3.44mm/5min）;（5.59±1.33s）,（6.82±3.05mm/5min）;（4.29±1.87s）,（6.04±3.15mm/5min）respectively after 1, 2 and 3mo of the treatment. There was significant decrease in BUT and ST after the treatment for 1, 2 and 3mo（P=0.00）.CONCLUSION： Travoprost eyedrops can obviously aggravate patients＇ corneal irritation after treatment. Our results show abnormal decreased tear secretion and stability of tear film induced by Travoprost eyedrops over the short term.