| Purpose To observe the ocular surface changes of glaucoma patients with dry eye symptoms after using benzalkonium chloride(BAK)and cyclosporine A eye drops(Cyclosporine A)to treat glaucoma drug-induced dry eye,and to explore the efficacy of cyclosporine A eye drops in the treatment of glaucoma drug-induced dry eye,so as to provide a basis for the treatment of glaucoma drug-induced dry eye.Method Sixty-six patients(131 eyes)with dry eye were selected as the study subjects,and they were randomly divided into control group(group A)32 cases(63 eyes)and observation group(group B)34 cases(68 eyes).All the subjects were divided into group according to different exposure levels of benzalkonium chloride(BAK)in the past year.Group A 1and Group B 1(exposure to BAK < 2000 mcg)and group A 2 and B 2(exposure to BAK >2000 mcg)were retrospectively analyzed.At the same time,the control group was treated with 0.1% sodium hyaluronate eye drops and 0.9% sodium chloride solution.The observation group was treated with 0.1% sodium hyaluronate eye drops combined with0.05% cyclosporine A eye drops.Best corrected visual acuity(BCVA),intraocular pressure,ocular surface disease index(OSDI),Schirmer I test(S I t),tear film break-up time(TFBUT),fluorescein staining(FL)and dendritic cell density(DCD)results were observed and analyzed before and after treatment for 1 month and 3 months..The data were analyzed statistically.Results:1.There was no significant difference in BCVA between group A1 and group A2 before and after treatment(P1 = 3.0833 P2 = 0.1396).There was no significant difference in BCVA between group B1 and group B2 before and after treatment(P1 = 0.9310 P2 = 0.1982);there was no significant difference in BCVA between group A1,group A2 and group B1 and group B2 after 3 mo treatment(P1 = 0.4283 P2 = 2.0195).2.There was no significant difference in IOP between group A1 and group B1 before and after treatment(P=0.2500 P=0.7065).The intraocular pressure of group A2 and group B2 after 3 mo treatment was 16.27 ±1.90 mm Hg and 16.44±1.59 mm Hg respectively,which was higher than that before treatment(15.40 ±2.48 mm Hg)and 15.49±2.34 mm Hg,but there was no significant difference(P=0.0517 P=0.0771).There was no significant change in intraocular pressure in control group A1,A2 and observation group B1 and B2 after treatment(P > 0.05).3.When the BAK exposure was less than 2000 mcg,the OSDI scores of group A1 and group B1 were 41.20±7.24 and 41.71±9.11 before treatment and 20.51±6.77 and10.46±3.57 after 3 mo of treatment,respectively.There was a significant difference before and after treatment(P=0.0001 P=0.0000).When the exposure of BAK was more than 2000 mcg,the OSDI scores of group A2 and group B2 were 40.68±6.85 and41.08±7.45 before treatment and 16.16±3.24 and 8.05±2.43 after 3 mo treatment,respectively with significant difference(P = 0.0001 P = 0.0000).The OSDI scores of control group A1,A2 and observation group B1 and B2 were significantly different after treatment(P<0.05).4.SIt results in group A1 and group B1 was 6.71±1.34 l/mm and 6.57±1.90 l/mm before treatment,and 8.20±1.24 l/mm and 10.31±1.67 l/mm after 3 months of treatment.Tear secretion increased after treatment.There was a significant difference between before and after treatment(P=0.0002 P=0.0036).The results of S_t in group A2 and group B2 were6.82±1.83 l/mm and 6.30±1.90 l/mm before treatment,and 9.84±1.70 l/mm and13.22±1.46 l/mm after 3 months of treatment.There were significant differences between the two groups before and after treatment(P=0.0058 P=0.0025).The control group A1,A2 and observation group B1 and B2 had no difference before treatment,but there was significant difference after treatment(P < 0.05).5.The results of TFBUT in group A1 and group B1 was 4.64±1.01t/s and 4.55±2.84t/s before treatment,and 7.07±1.26t/s and 7.75±1.52t/s after 3 months of treatment,respectively.There was a significant difference between the two groups(P=0.0012P=0.0015).The results of TFBUT in group A2 and group B2 were 4.58±2.51t/s and 4.84±2.04t/s before treatment,and 8.36±2.16t/s and 6.18±1.58t/s after 3 months of treatment.There was significant difference before and after treatment(P=0.0002 P=0.0010).The control group A1,A2 and observation group B1 and B2 had no difference before treatment,but there was significant difference after treatment(P < 0.05).6.The results of FL in A1 group and B1 group before treatment were 8.88±1.05 and8.69±1.90,respectively.After 3 mo treatment,the results of FL in A1 group and B1 group were 3.88±1.05 and 3.09±1.95.After treatment,the scores of fluorescein staining of cornea decreased,and the difference was statistically significant(P=0.0001 P=0.0001).The results of FL in group A2 and group B2 were 7.58±1.09 and 7.83±1.08 before treatment and 3.89±1.11 and 3.29±1.39 after 3 mo of treatment.The corneal epithelial defect in group A2 and group B2 was improved after treatment,with significant difference(P=0.0021 P=0.0001).The FL results of control group A1,A2 and observation group B1 and B2 had no difference before treatment,but there was significant difference after treatment(P < 0.05).7.The results of DCD in A1 group and B1 group before treatment were 84.68±6.25cells/mm,83.75±5.51cells/mm,26.84±3.59cells/mm and 21.75±4.86cells/mm respectively after 3months of treatment.Dendritic cell density decreased after treatment,with significant difference(P=0.0002 P=0.0001).The results of DCD in group A2 and group B2 were87.25±5.18 cells/mm_and 88.81±6.32 cells/mm_before treatment,and 28.25±3.89cells/mm_and 23.18±8.94 cells/mm after 3 months of treatment.There were significant differences between the two groups(P=0.0001 P=0.0001).The DCD results of control group A1,A2 and observation group B1 and B2 had no difference before treatment,but there was significant difference after treatment(P < 0.0500).Conclusion1.Dendritic cells in cornea under confocal microscopy are one of the important markers of nonspecific inflammation in drug-induced dry eyes of glaucoma patients,and their density changes can be used as a reference for evaluating the severity of inflammation.2.Low concentration of cyclosporine A eye drops has important value in alleviating drug-induced dry eye in glaucoma patients. |
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