Xia Yu, Blecher Nathaniel A, Custer Philip L, Sieck Erin G
Medical Scientist Training Program, Washington University School of Medicine, St. Louis, MO, 63110, USA.
Department of Ophthalmology & Visual Sciences, Washington University School of Medicine, St. Louis, MO, 63110, USA.
Am J Ophthalmol Case Rep. 2024 Jul 18;36:102111. doi: 10.1016/j.ajoc.2024.102111. eCollection 2024 Dec.
To report the observation that the efficacy of topical glaucoma treatment improved after surgical correction of ectropion in a 71-year-old male with a known history of glaucoma.
The patient initially presented for tearing and lid malposition and was found to have bilateral elevated intraocular pressures (IOP) in addition to bilateral lower eyelid ectropion. IOP control was initially prioritized over ectropion repair, with IOP remaining elevated despite topical glaucoma treatment and selective laser trabeculoplasty. Sequential unilateral ectropion repair was then carried out, with topical glaucoma treatment resumed after the first repair. It was observed that the IOP improved with topical glaucoma treatment on each side after ectropion repair, despite no changes to medications nor dosing.
The efficacy of topical glaucoma treatment is dependent on drop availability and absorption. While recent efforts to increase drop efficacy have been focused on engineering formulations that increase retention or corneal penetration, our case highlights that in selected glaucoma patients, correction of lid malposition may serve as an effective way to improve drop efficacy.
报告一名有青光眼病史的71岁男性患者，睑外翻手术矫正后局部青光眼治疗效果改善的观察结果。
患者最初因流泪和眼睑位置异常就诊，除双侧下睑外翻外，还发现双侧眼压升高。最初优先控制眼压而非修复睑外翻，尽管进行了局部青光眼治疗和选择性激光小梁成形术，但眼压仍居高不下。随后进行了序贯性单侧睑外翻修复，首次修复后恢复局部青光眼治疗。观察发现，睑外翻修复后，尽管药物和剂量均未改变，但局部青光眼治疗使每侧眼压均有所改善。
局部青光眼治疗的效果取决于滴眼液的可用性和吸收情况。虽然最近提高滴眼液疗效的努力主要集中在设计能增加药物滞留或角膜穿透性的制剂上，但我们的病例表明，在部分青光眼患者中，矫正眼睑位置异常可能是提高滴眼液疗效的有效方法。
