Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway.
The Norwegian Dry Eye Clinic, Oslo, Norway.
Acta Ophthalmol. 2024 Nov;102(7):735-748. doi: 10.1111/aos.16728. Epub 2024 Jun 1.
One of the most common causes of blindness on a global scale is glaucoma. There is a strong association between glaucoma and increased intraocular pressure (IOP). Because of this, adequate IOP-lowering is the most important treatment strategy, mostly through topical eyedrops. Well-functioning meibomian glands are paramount for maintaining a stable tear film, and their dysfunction is the most common cause of dry eye disease. There is a growing concern that both topical glaucoma medications themselves and their added preservatives damage the meibomian glands, and consequently, the ocular surface. Preserved topical glaucoma medications appear to cause dysfunction and atrophy of the meibomian glands. Upon comparison, preserved formulations caused more symptoms of dry eye, tear film instability, inflammatory changes and meibomian gland dropout than the preservative-free counterpart. However, although seemingly less detrimental, unpreserved alternatives may diminish glandular efficacy, and, depending on the active ingredient, lead to glandular death. This negatively impacts quality of life, adherence to treatment regimens and prognosis. In this review, we explore the available evidence regarding the effects of IOP-lowering eye drops on the meibomian glands.
在全球范围内，导致失明的最常见原因之一是青光眼。青光眼与眼内压（IOP）升高之间存在很强的关联。因此，充分降低眼压是最重要的治疗策略，主要通过局部滴眼剂。功能良好的睑板腺对于维持稳定的泪膜至关重要，而其功能障碍是干眼症最常见的原因。人们越来越担心局部青光眼药物本身及其添加的防腐剂会损害睑板腺，从而影响眼表面。保存的局部青光眼药物似乎会导致睑板腺功能障碍和萎缩。相比之下，与不含防腐剂的药物相比，保存配方会导致更多的干眼症状、泪膜不稳定、炎症变化和睑板腺缺失。然而，尽管看起来危害较小，但未保存的替代品可能会降低腺体的功效，并且根据有效成分的不同，会导致腺体死亡。这会对生活质量、治疗方案的依从性和预后产生负面影响。在这篇综述中，我们探讨了关于降低眼压滴眼剂对睑板腺影响的现有证据。
