Lajmi Houda, Hmaied Wassim, Achour Besma Ben, Zahaf Amin
Department of Ophthalmology, Internal Security Forces Hospital, La Marsa, Tunis, Tunisia.
J Curr Ophthalmol. 2021 Jul 5;33(2):128-135. doi: 10.4103/JOCO.JOCO_226_20. eCollection 2021 Apr-Jun.
To study the clinical and the functional findings in glaucomatous patients under preserved eye drops having ocular surface alterations and to analyze their risk factors.
A cross-sectional study of 155 glaucomatous patients was conducted. All of them answered the "Ocular Surface Disease Index" (OSDI) questionnaire and had a complete and precise evaluation of the ocular surface state including a Schirmer I test, a tear break-up time evaluation, eyelid, conjunctival, and corneal examination with a Fluorescein and a Lissamin green test. We studied factors that could influence the OSDI score and each type of ocular surface alteration (age, sex, glaucoma treatment duration, number and type of the active principle, and Benzalkonium Chloride [BAK] use).
BAK was used in 80% of cases. The OSDI score was ≥13, in 61.3% of cases. The biomicroscopic signs of ocular surface disease were at least minimal in 87.1% of cases. The main predictors of OSDI score increase were the glaucoma treatment duration ( = 0.01, = 2.618), the number of molecules used ( = 0.018, = 2.391), and the use of BAK ( = 0.011, = 2.58). The severity of the biomicroscopic signs correlated with these same risk factors. Fixed combination was statistically associated with a lower incidence of superficial punctate keratitis (SPK) and corneal and conjunctival staining in the Lissamine green test ( < 0.001). Beta-blockers were associated with a significantly higher risk of SPK and corneal or conjunctival staining in the Lissamine green test ( < 0.001).
Preserved antiglaucomatous eye drops alter the patients' ocular surface. The main risk factors were advanced age, duration of glaucoma treatment, multiple therapies, and the use of BAK.
研究使用保存型滴眼液且存在眼表改变的青光眼患者的临床和功能表现，并分析其危险因素。
对155例青光眼患者进行了一项横断面研究。他们都回答了“眼表疾病指数”（OSDI）问卷，并对眼表状态进行了完整而精确的评估，包括Schirmer I试验、泪膜破裂时间评估、使用荧光素和丽丝胺绿试验进行眼睑、结膜和角膜检查。我们研究了可能影响OSDI评分和每种眼表改变类型的因素（年龄、性别、青光眼治疗持续时间、活性成分的数量和类型以及苯扎氯铵[BAK]的使用情况）。
80%的病例使用了BAK。61.3%的病例OSDI评分≥13。87.1%的病例眼表疾病的生物显微镜体征至少为轻度。OSDI评分增加的主要预测因素是青光眼治疗持续时间（P = 0.01，β = 2.618）、使用的分子数量（P = 0.018，β = 2.391）和BAK的使用（P = 0.011，β = 2.58）。生物显微镜体征的严重程度与这些相同的危险因素相关。固定复方制剂在丽丝胺绿试验中与浅层点状角膜炎（SPK）以及角膜和结膜染色的发生率较低具有统计学关联（P < 0.001）。β受体阻滞剂在丽丝胺绿试验中与SPK以及角膜或结膜染色的风险显著更高相关（P < 0.001）。
保存型抗青光眼滴眼液会改变患者的眼表。主要危险因素是高龄、青光眼治疗持续时间、多种治疗方法以及BAK的使用。
