Hegde Vijay, Robinson R, Dean F, Mulvihill H A, Ahluwalia H
Princess Alexandra Eye Pavilion, Edinburgh, United Kingdom.
Ophthalmology. 2007 Feb;114(2):362-6. doi: 10.1016/j.ophtha.2006.09.032.
To review cases of possible drug-induced ectropion and recommend what we consider to be best practice.
Retrospective observational case series.
Thirteen consecutive outpatients.
Records of 13 outpatients on topical medication presenting with topical drug-induced ectropion were retrospectively analyzed.
Eyelid position, topical agent causing the allergy, and medical and surgical management options.
In all 13 patients, the ectropion resolved partially or completely after discontinuing the offending topical agent. Dorzolamide (53%) was the most common offending agent, followed by brimonidine (23%). One of the 13 patients underwent failed ectropion surgery correction before referral, but improved once the topical agent was discontinued. Two of the patients successfully underwent surgical correction for ectropion after discontinuing their topical therapy. Those patients who discontinued the topical therapy and had a short course of steroid therapy did not require surgical correction.
This study demonstrates that sensitivity to topical agents can induce ectropion in more than 1 manner. Chronic exposure to the causative agent leads to cicatricial changes in the anterior lamella of the eyelid in susceptible individuals, and can manifest as contact dermatitis leading to tissue edema and mechanical ectropion. Early recognition of this condition and discontinuation of therapy is of paramount importance; it may lead to complete resolution. Topical steroids are a necessary adjunct in the management of drug-induced ectropion. Based on our experience, we propose a management algorithm for drug-induced ectropion.
回顾可能由药物引起的睑外翻病例，并推荐我们认为的最佳治疗方法。
回顾性观察病例系列。
连续13名门诊患者。
对13名使用局部药物后出现局部药物性睑外翻的门诊患者的记录进行回顾性分析。
眼睑位置、引起过敏的局部用药、药物及手术治疗方案。
所有13例患者在停用引起问题的局部药物后，睑外翻部分或完全缓解。多佐胺（53%）是最常见的致病药物，其次是溴莫尼定（23%）。13例患者中有1例在转诊前睑外翻手术矫正失败，但停用局部药物后病情改善。2例患者在停用局部治疗后成功接受了睑外翻手术矫正。那些停用局部治疗并接受短期类固醇治疗的患者无需手术矫正。
本研究表明，对局部药物的敏感性可通过多种方式诱发睑外翻。在易感个体中，长期接触致病因素会导致眼睑前层出现瘢痕性改变，并可表现为接触性皮炎，导致组织水肿和机械性睑外翻。早期识别这种情况并停止治疗至关重要；这可能会导致完全缓解。局部类固醇是药物性睑外翻治疗中必要的辅助药物。基于我们的经验，我们提出了一种药物性睑外翻的治疗算法。
