Comparison of the short-term effects on the human corneal surface of topical timolol maleate with and without benzalkonium chloride
Comparison of the short-term effects on the human corneal surface of topical timolol maleate with and without benzalkonium chloride
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DOI：
10.1097/00061198-200312000-00008
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发表时间：
2003-12-01
影响因子：
2
通讯作者：
Kinoshita, S
中科院分区：
文献类型：
--
作者：
Ishibashi, T;Yokoi, N;Kinoshita, S
目的：比较含和不含防腐剂（0.005%苯扎氯铵）的马来酸噻吗洛尔对角膜前泪膜稳定性和角膜上皮屏障功能的短期影响。
受试者和方法：研究对象为20名健康志愿者。为获取基线值，在实验前7天，使用泪膜镜测量角膜前泪膜的非侵入性破裂时间；用荧光光度计测量角膜荧光素摄取量。将不含防腐剂或含防腐剂的0.5%噻吗洛尔滴入一只眼；对侧眼使用另一种药物。滴入后30分钟，重复实验前的检测。
结果：含防腐剂的噻吗洛尔使非侵入性破裂时间较基线值显著降低（含防腐剂的噻吗洛尔基线值和暴露后值分别为11.4秒和6.8秒，P = 0.008；不含防腐剂的噻吗洛尔为11.7秒和11.0秒，P = 0.55），而不含防腐剂的噻吗洛尔则无此现象。另一方面，无论是接触含防腐剂的还是不含防腐剂的噻吗洛尔，角膜荧光素摄取量均显著增加（含防腐剂的噻吗洛尔基线值和暴露后值分别为37.5纳克/毫升和82.0纳克/毫升，P < 0.001；不含防腐剂的噻吗洛尔为35.4纳克/毫升和57.6纳克/毫升，P < 0.001）。含防腐剂的噻吗洛尔作用更显著（P = 0.028）。
结论：接触含防腐剂的噻吗洛尔导致角膜前泪膜明显不稳定。此外，它对角膜上皮屏障功能的破坏程度比不含防腐剂的噻吗洛尔更大。在保护角膜表面完整性及其与泪膜的相互作用方面，去除防腐剂可能是可取的。
Purpose: To compare the short-term effects of timolol maleate with and without preservative (0.005% benzalkonium chloride) on precorneal tear film stability and corneal epithelial barrier function.Subjects and Methods: The study population consisted of 20 healthy volunteers. To obtain baseline values, 7 days before the experiment the non-invasive breakup time of the pre-corneal tear film was measured using a tear specular microscope; corneal fluorescein uptake was measured with a fluorophotometer. Unpreserved or preserved 0.5% timolol was applied to one eye; the contralateral eye was exposed to the other drug. At 30 minutes after instillation, the pre-study tests were repeated.Results: Preserved timolol did, while unpreserved timolol did not, significantly reduce the non-invasive breakup time from the baseline values (baseline and post-exposure values 11.4 and 6.8 seconds, respectively,P=0.008 for preserved timolol, and 11.7 vs. 11.0 seconds, P = 0.55 for unpreserved timolol). Corneal fluorescein uptake, on the other hand, was significantly increased upon exposure to either preserved or unpreserved timolol (baseline and post-exposure values 37.5 and 82.0 ng/ml, P < 0.001 for preserved timolol, and 35.4 vs. 57.6 ng/ml, P < 0.001 for unpreserved timolol). Preserved timolol exerted the greater effect (P = 0.028).Conclusions: Exposure to preserved timolol resulted in significant instability in the pre-corneal tear film. Moreover, it disrupted the corneal epithelial barrier function to a greater degree than unpreserved timolol. The elimination of preservatives may be desirable in efforts to protect the integrity of the corneal surface and its interaction with the tear film.