Konowal A, Morrison J C, Brown S V, Cooke D L, Maguire L J, Verdier D V, Fraunfelder F T, Dennis R F, Epstein R J
Department of Ophthalmology, Rush Presbyterian-St Luke's Medical Center, Chicago, Illinois 60012, USA.
Am J Ophthalmol. 1999 Apr;127(4):403-6. doi: 10.1016/s0002-9394(98)00438-3.
To describe irreversible corneal decompensation after topical dorzolamide hydrochloride (Trusopt; Merck and Co, Inc, West Point, Pennsylvania) therapy in nine patients who had histories consistent with corneal endothelial compromise.
Multicenter review of patients' charts.
Nine eyes of nine patients developed overt corneal decompensation after starting topical dorzolamide, a condition that did not resolve with drug cessation. This occurred after 3 to 20 weeks (mean, 7.8) of therapy. All nine patients had undergone intraocular surgery. Eight patients had undergone cataract surgery; three were aphakic and three had posterior chamber intraocular lenses. Two patients had anterior chamber intraocular lenses and also had undergone trabeculectomies. Four patients had undergone penetrating keratoplasties, each case complicated by episodes of corneal allograft rejection that were successfully treated. Two patients had asymptomatic Fuchs endothelial dystrophy. Seven patients have since undergone successful penetrating keratoplasties.
The reports suggest that dorzolamide can cause irreversible corneal edema in a subset of glaucoma patients with endothelial compromise. The findings suggest a rationale for research into the long-term effects of dorzolamide on the corneal endothelium.
描述9例有角膜内皮受损病史的患者在局部应用盐酸多佐胺（Trusopt；默克公司，宾夕法尼亚州西点）治疗后发生的不可逆角膜失代偿情况。
对患者病历进行多中心回顾。
9例患者的9只眼在开始局部应用多佐胺后出现明显的角膜失代偿，停药后病情未缓解。这发生在治疗3至20周（平均7.8周）后。所有9例患者均接受过眼内手术。8例患者接受过白内障手术；3例为无晶状体眼，3例植入了后房型人工晶状体。2例患者植入了前房型人工晶状体，还接受了小梁切除术。4例患者接受过穿透性角膜移植术，每例均合并角膜移植排斥反应，经成功治疗。2例患者有无症状的Fuchs内皮营养不良。此后7例患者成功接受了穿透性角膜移植术。
这些报告提示，多佐胺可在一部分有内皮受损的青光眼患者中引起不可逆的角膜水肿。这些发现为研究多佐胺对角膜内皮的长期影响提供了理论依据。
