Yang Hee Kyung, Park Ki Ho, Kim Tae-Woo, Kim Dong Myung
Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.
Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute, Seoul, Korea.
Jpn J Ophthalmol. 2009 Mar;53(2):176-179. doi: 10.1007/s10384-008-0623-x. Epub 2009 Mar 31.
Topical travoprost, a prostaglandin F(2alpha) (PGF(2alpha)) analog, has several well-known side effects, including a darkening of the eyelid and eyelash hypertrichosis, but there are no reports of a deepening of the eyelid superior sulcus associated with its use.
We examined one patient with unilateral normal-tension glaucoma and another with unilateral primary open-angle glaucoma, both of whom were treated with travoprost monotherapy unilaterally for 2 years.
Both patients gradually developed a deepening of the eyelid superior sulcus with hyperpigmentation in the eyelid skin of the treated eye. The disparity between the treated eye and the fellow eye was quite visible. However, the disparity returned to normal after discontinuation of travoprost for 15 months. A deepening of the eyelid superior sulcus is more significant in Asians, who seldom have an eyelid crease or deep sulcus. One proposed mechanism is a mechanical insult to the eyelid causing levator dehiscence. A second possible mechanism is fatty degeneration and reduced collagen fibers in the levator complex caused by the PGF(2alpha) analog. However, the exact mechanism remains to be determined.
A deepening of the eyelid superior sulcus should be considered a possible complication of topical travoprost that can be reversed by discontinuation of the medication.
局部用曲伏前列素，一种前列腺素F(2α)（PGF(2α)）类似物，有几种众所周知的副作用，包括眼睑变黑和睫毛多毛症，但尚无关于使用该药导致眼睑上沟加深的报道。
我们检查了一名单侧正常眼压性青光眼患者和另一名单侧原发性开角型青光眼患者，两人均单侧使用曲伏前列素单药治疗2年。
两名患者均逐渐出现治疗眼眼睑上沟加深，并伴有治疗眼眼睑皮肤色素沉着。治疗眼与对侧眼之间的差异非常明显。然而，停用曲伏前列素15个月后，差异恢复正常。眼睑上沟加深在亚洲人中更为显著，他们很少有眼睑皱襞或深沟。一种推测的机制是对眼睑的机械性损伤导致提上睑肌裂开。另一种可能的机制是PGF(2α)类似物导致提上睑肌复合体脂肪变性和胶原纤维减少。然而，确切机制仍有待确定。
应将眼睑上沟加深视为局部用曲伏前列素可能的并发症，停药后可逆转。
