目的:通过观察长期应用抗青光眼滴眼剂作用后结膜炎症反应的发生和炎性标记物ICAM-1在眼部的表达,探讨长期应用抗青光眼滴眼剂对结膜反应的影响。方法:从我科收住的原发性开角型青光眼患者90例,分为三组:应用5g/L噻吗洛尔与2g/L阿法根(联合用药组)30例;应用5g/L噻吗洛尔(单一用药组)30例;未用药组30例;单纯白内障患者作为空白对照组30例。按抗青光眼药物治疗时间及白内障患病时间分为三个时相(0～6mo,7～12mo,13～18mo)组,各个时相组10例,进行结膜上皮组织形态学观察及检测结膜上皮组织中ICAM-1炎性标记物的表达。结果:单一用药组在用药13～18mo时其球结膜组织学改变明显,表现为上皮形态不规则,表面不平或有上皮分离或增生,球结膜下纤维结缔组织排列不规则,小血管增多,巨噬细胞、淋巴细胞、成纤维细胞数增多。联合用药组在用药13～18mo时球结膜有明显的组织学改变,上皮有不同程度的增生或鳞状化生,上皮厚薄不均,表面不光滑,有上皮脱落,球结膜下组织中小血管增多,巨噬细胞、淋巴细胞、成纤维细胞数目明显增多、杯状细胞减少。单一用药组与联合用药组在13～18mo结膜组上皮组织中含ICAM-1抗原的阳性细胞数与其他组差别有统计学意义(P<0.01)。结论:长期联合应用抗青光眼药物可致结膜组织的炎性反应,结膜上皮组织中的炎性标记物ICAM-1表达明显增加。 Objective: To observe the occurrence of conjunctival inflammatory reaction and the expression of ICAM-1, an inflammatory marker, in the eye after long-term application of anti-glaucoma eye drops to investigate the effect of long-term anti-glaucoma eye drops on conjunctival response. Methods: Ninety patients with primary open-angle glaucoma admitted from our department were divided into three groups: 30 cases were treated with 5 g / L timolol and 2 g / L afar (combination group) L timolol (single drug group) 30 cases; no drug group 30 cases; simple cataract patients as blank control group 30 cases. According to the anti-glaucoma treatment time and cataract prevalence time were divided into three phases (0 ~ 6mo, 7 ~ 12mo, 13 ~ 18mo) group, 10 cases of each phase group, morphological observation of conjunctival epithelium and detection of conjunctival epithelium Expression of ICAM-1 inflammatory markers in tissues. Results: The histological changes of the conjunctiva in the single drug group were obvious at 13 ~ 18 months after treatment, showing irregular epithelial morphology, uneven surface or epithelial separation or hyperplasia, irregular arrangement of subconjunctival fibrous connective tissue, small blood vessels, Increased number of phagocytes, lymphocytes and fibroblasts. In the combination group, there was obvious histological change of the conjunctiva in 13 ~ 18 months after treatment. The epithelial cells had different degrees of hyperplasia or squamous metaplasia, uneven thickness of the epithelium, unsmooth surface, epithelial shedding, small and medium vessels in the subconjunctival tissue , Macrophages, lymphocytes, fibroblasts significantly increased the number of goblet cells decreased. The number of positive cells containing ICAM-1 antigen in the epithelium of the conjunctiva group between the single drug group and the combination group was significantly different from other groups (P <0.01). Conclusion: Long-term combined anti-glaucoma drug can cause inflammatory reaction of conjunctival tissue, and the expression of ICAM-1, an inflammatory marker in conjunctival epithelium, is significantly increased.