Ophthalmic Consultants of Boston.
New England Eye Center, Tufts University School of Medicine, Boston, Massachusetts, USA.
Curr Opin Ophthalmol. 2021 Mar 1;32(2):134-140. doi: 10.1097/ICU.0000000000000739.
Glaucoma patients commonly suffer from ocular surface disease (OSD). As treatment strategies, medications and devices for the treatment of OSD as well as glaucoma surgical approaches evolve rapidly, it is important to consider their application to these patients.
OSD in glaucoma patients may lead to reduced reliability of diagnostic tests, decreased medication compliance, poor surgical outcomes, and overall decreased quality of life. Chronic use of topical glaucoma medications has been linked to the development of limbal stem cell deficiency, and the role of preservatives in OSD continues to be demonstrated. Preservative free glaucoma medications as well as new anti-inflammatory agents for the treatment of OSD are now available. Omega-3 fatty acid supplementation and punctal plugs have been shown to benefit glaucoma patients with OSD. Drop burden may be reduced through the use of the new sustained-release delivery systems, selective laser trabeculoplasty, and minimally invasive glaucoma surgery.
There are multiple emerging strategies for managing OSD that may be applied to patients with glaucoma. With continued research and clinical experiences, we hope to better understand the multifaceted relationship between glaucoma and OSD and develop evidence-based algorithms for the management of these complex patients.
目的综述：青光眼患者常伴有眼表疾病（OSD）。随着治疗眼表疾病（OSD）以及青光眼手术方法的药物和设备的治疗策略的快速发展，考虑将这些方法应用于这些患者非常重要。
最近发现：青光眼患者的 OSD 可能导致诊断测试的可靠性降低、药物依从性降低、手术效果差以及整体生活质量下降。局部使用青光眼药物的慢性使用与角膜缘干细胞缺乏有关，防腐剂在 OSD 中的作用仍在不断被证明。目前已有不含防腐剂的青光眼药物和新的抗炎药物可用于治疗 OSD。ω-3 脂肪酸补充剂和泪小点栓子已被证明对患有 OSD 的青光眼患者有益。通过使用新的缓释输送系统、选择性激光小梁成形术和微创青光眼手术，可以减少滴眼次数。
总结：有多种治疗 OSD 的新兴策略可应用于青光眼患者。随着进一步的研究和临床经验，我们希望能更好地理解青光眼和 OSD 之间的多方面关系，并为这些复杂患者制定基于证据的治疗方案。
