人工泪液对局部应用抗青光眼药物造成眼表损伤的预防作用

目的　探讨人工泪液对局部应用抗青光眼药物造成眼表损伤的预防作用。方法　选取已确诊为原发性开角型青光眼并需局部应用抗青光眼药物治疗的患者５０例（５０眼），随机分为观察组与对照组，各２５例（２５眼），对照组患者只给予抗青光眼药物治疗，观察组患者给予抗青光眼药物与人工泪液治疗，并于治疗前及治疗３个月后对所有观察对象行眼压测量、泪膜破裂时间（ｂｒｅａｋ-ｕｐｔｉｍｅ，ＢＵＴ）、ＳｃｈｉｒｍｅｒⅠ试验（ＳｃｈｉｒｍｅｒⅠ ｔｅｓｔ，ＳⅠｔ）及角膜荧光素钠染色评分检查。结果　对照组与观察组治疗后眼压分别为（１７．００±２．１０）ｍｍＨｇ（１ｋＰａ＝７．５ｍｍＨｇ）和（１６．７２±２．２８）ｍｍＨｇ，都明显低于治疗前的（３３．５６±４．０９）ｍｍＨｇ和（３３．７２±３．９８）ｍｍＨｇ，差异均有统计学意义（均为Ｐ＝０．０００）。对照组治疗３个月后ＢＵＴ（６．４４±１．７６）ｓ较治疗前（９．９２±１．９９）ｓ明显缩短，差异有统计学意义（ｔ＝５．６１８，Ｐ＝０．０００）；观察组治疗后ＢＵＴ与治疗前相比，差异无统计学意义（Ｐ＞０．０５）；对照组治疗３个月后ＢＵＴ较观察组（９．００±１．５３）ｓ明显缩短，差异有统计学意义（ｔ＝－６．４６２，Ｐ＝０．０００）。对照组以及观察组治疗前后ＳⅠｔ比较差异均无统计学意义（均为Ｐ＞０．０５）；治疗３个月后，两组间ＳⅠｔ比较差异无统计学意义（Ｐ＞０．０５）。对照组角膜荧光素钠染色评分治疗后为（３．０８±１．３５）较治疗前（０．８８±０．７３）明显增加，差异有统计学意义（ｔ＝－８．１２４，Ｐ＝０．０００）；观察组治疗后与治疗前相比，差异无统计学意义（Ｐ＞０．０５）；治疗３个月后对照组角膜荧光素钠染色评分（３．０８±１．３５）较观察组（１．００±０．５８）明显增加，差异有统计学意义（ｔ＝７．５２５，Ｐ＝０．０００）。结论　人工泪液可减轻局部应用抗青光眼药物所造成的眼表损害，有一定的预防作用，同时对抗青光眼药物疗效无明显影响。

Preventive effect of artificial tears on ocular surface damage due to anti-glaucoma medicine

Objective To observe the preventive effect of artificial tears on ocular surface damage due to anti-glaucoma medicine. Methods All 50 patients ( 50eyes) with primary open angle glaucoma and local anti-glaucoma drugs were selected and randomly divided into observation group and control group ,25 patients in each group , the patients in control group were only given anti-glaucoma medicine .the observation group given anti-glaucoma medicine and artificial tears. All patients were evaluated intraocular pressure ( IOP) . tear break-up time ( BUT ) , Schirmer I test ( SIt ) , and corneal fluorescein staining( FL) before treatment and 3 months after treatment. Results The IOP after treatment of control group and observation group ( 17. 00 + 2. 10) mmHg ( I kPa = 7. 5 mmHg) and ( 16. 72 + 2. 28 ) mmHg , respectively , were significantly lower than before treatment ( 33. 56 +4. 09 ) mmHg and ( 33. 72 + 3. 98 ) mmHg , the differences were statistically significant ( all P = 0. 000) . BUT in the control group after treatment was ( 6. 44 + 1. 76) seconds.shorter than before treatment ( 9. 92 + 1. 99 ) seconds , the difference was statistically sigruficant ( t = 5. 618 .P = 0. 000 ) ; In the observation group the difference was not statistically significant (P > 0. 05 ) ; After 3 months of treatment, the control group ( 6. 44 + I . 76 ) seconds was significantly shorter than that of the observation group (9. 00 + 1. 53 ) seconds , the difference was statistically sigruficant ( t = - 6. 462 . P = 0. 000 ) . The difference in SIt results before and after treatment in the control group and observation group was not statistically sigruficant ( all P > 0. 05 ) ; After 3 months of treatment .there was no significant difference between the two groups (P > 0. 05 ) . FL score in the control group after treatment ( 3. 08 + 1. 35 ) was higher than before treatment ( 0. 88 +0. 73 ) significantly , the difference was statistically significant ( t = - 8. 124 .P = 0. 000) ;The difference before and after treatment in the observation group was not statistically sigruficant ( P > 0. 05 ) ; After 3 months of treatment . the control group ( 3. 08 + 1. 35 ) was significantly increased compared with the observation group ( 1. 00 + 0. 58 ) . and the difference was statistically significant ( t = 7. 525 ,P = 0. 000 ) . Conclrision The artificial tears can reduce the ocular surface damage due to long-term use of topical anti-glaucoma medicine. and there is a certain preventive effect with no obvious effect on the efficacy of anti-glaucoma medicine.