摘要目的 探讨药物源性角膜病变的临床特征及诊治方法.方法 回顾药物源性角膜病变的患者18例(24只眼),记录既往史,初诊症状,体征,诊断,治疗,发生药物源性角膜病变后症状,体征,治疗措施及疗效.结果 发生药物源性角膜病变后,1例双眼角膜弥漫性卷丝,3例角膜上皮呈飓风样改变,6例角膜上皮弥漫性脱落,5例角膜上皮片状脱落,基质水肿,2例角膜溃疡溶解,1例角膜穿孔.18例中16例由误诊导致错误用药引起,l例长期自行使用表麻药引起,1例抗病毒药物未及时减量引起.治疗方法:停用原用药物,角膜溃疡、穿孔的患者施行结膜瓣遮盖术或角膜移植术,其余14例,使用人工泪液、激素治疗,同时治疗原发病.治疗周期3天至2个月.结论 药物源性角膜病变表现多样,容易误诊.有药物源性角膜病变易感因素的患者,在不合理用药的情况下容易导致药物源性角膜病变的发生.

abstractsObjective To study the pathogenesis,clinical characteristic and therapeutic methods of drug-induced keratopathy.Methods The clinical data of 18 cases (26 eyes) with drug-induced keratopathy were retrospectively analyzed.Results The clinical manifestations of the drug-induced keratopathy were as follows.Severe volume filamentous keratitis (one case),punctate corneal epithelial defects (nine cases),flakiness corneal epithelial defects accompanying corneal stroma edema (5 cases),and corneal ulcer and even corneal perforation (3 cases) were observed.Sixteen cases were resulted from drug misuse because of misdiagnosis,and the other 2 cases were respectively resulted from long-term usage of topical anesthetic and failure of discontinuation of antiviral agent.Stopping the irrational drug use,paired with artificial tears and steroid hormone were effective in the 14 mild to moderate cases.Other 4 severe cases underwent surgeries.Conclusions Drug-induced keratopathy was complex and has no typical manifestation,which make it easy to be misdiagnosed.It is mainly caused by abuse of topical drugs on the ocular surface especially in the vulnerable group.