Objective:To study the effects of long-time local glaucoma agents on the ocular surface structure and function in glaucom patients. Methods:62glaucoma patients(92eyes)with local glaucoma agents for 3months were divided into group A( one kind of glaucoma agents) consists of1%Pilocarpine in 8 cases ( 16 eyes ) , 0 . 5%Timolol in 9 cases ( 12 eyes ) , 0 . 2%Alphagan in 7 cases ( 14 eyes ) , 1%Brinzolamide in 8 cases ( 12 eyes ) , and group B ( two kinds of glaucoma agents ) consists of1%Pilocarpine +1% brinzolamide in 9 cases(15eyes),5%Timolol +0. 2%Alphagan in 15 cases(21eyes) and1%Pilocarpine +1%Azopt+0. 2%Alphagan in 6 cases(8eyes),and selected 30 healthy volunteers (30eyes)as the control group,compared Schirmer test I(ST),tear film break-up time(BUT),corneal fluorescein staining(FL) and conjunctival impression cell(CIC)Rating. Results:A group SIt was(8. 51 ±4. 76)mm/5min,BUT was(8. 46 ±4. 24) s,FL score was(2. 91 ±1. 03);B group ST was(6. 34 ± 2. 05)mm/5min,BUT was(6. 38±2. 23)s,FL score was(3. 84±1. 14);Control group SIt was(10. 72±4.62)mm/5min,BUT was(11.45±5.12)s,FL score was(0.62±0.04). The difference between the three groups was statistically significant(F=21. 763,P=0. 000;F=18. 848,P=0. 000;F=25. 418,P=0 . 000 ) . CIC Rating of A and B groups were Ⅱ~Ⅲ and the ratio is 45 . 83%and 68 . 18%, which was higher than that of the control group 6. 67%(X2=28. 266,P=0. 000). Conclusion:long-term local glaucoma agents lead to tear secretion decreased,tear break-up time shortened,and conjunctival goblet cells reduced,which destroy the stability of tear film caused by ocular surface injury. Increaseing the types of drugs will aggravate the damage.%目的：：研究长期使用青光眼药物对病人眼表结构和功能的影响。方法：将使用青光眼局部药物≥3mo的病人62例(92只眼),分为A组(使用一种药物)：1%毛果芸香碱8例(10只眼),0.5%噻吗心安9例(12只眼),0.2%阿法根7例(14只眼),1%派立明8例(12只眼)和B组(使用两种及以上药物)：1%毛果芸香碱+1%派立明9例(15只眼),5%噻吗心安+0.2%阿法根15例(21只眼),1%毛果芸香碱+1%派立明+0.2%阿法根6例(8只眼),选择健康志愿者30例(30只眼)为对照组,对所有观察对象进行基础泪液分泌试验(SIt)、泪膜破裂时间(BUT)测定、角膜荧光染色(FL)及结膜印记细胞学检查(CIC)。结果：A组SIt(8.51±4.76)mm/5min, BUT (8.46±4.24)s,FL评分为(2.91±1.03)；B组 ST(6.34±2.05)mm/5min,BUT (6.38±2.23)s,FL 评分为(3.84±1.14)；对照组SIt(10.72±4.62)mm/5min,BUT(11.45±5.12)s,FL评分为(0.62±0.04),三组两两相比差异都具有统计学意义(F=21.763,P=0.000；F=18.848,P=0.000；F=25.418,P=0.000)。 A组和B组CIC评级为Ⅱ~Ⅲ级,比例为45.83%和68.18%,高于对照组的6.67%(X=28.266,P=0.000)。结论：长期局部使用抗青光眼药物,会造成泪液分泌减少、泪膜破裂时间缩短以及结膜杯状细胞减少,从而破坏泪膜稳定性造成眼表面损伤,增加用药种类会加重这种损害。
展开▼
