3.1 Involvement of ocular surface and appendages
The most common symptoms are discomfort of the eyelids, conjunctiva and
lacrimal gland organs, including dry eye [2], nasolacrimal duct
obstruction [16], lacrimal duct obstruction [16-18], erosive
conjunctivitis and punctate stenosis [4], corneal epithelial lesions
[19, 20], and limbal stem cell deficiency [3]. The obstruction
of nasolacrimal duct may be related to the interstitial fibrosis of
lacrimal duct mucosa [16]. And conjunctiva, keratopathy and dry eye
may be related to the cytotoxicity of the drug. The drug inhibits cell
proliferation in the cornea and eye surface, leading to stem cell
dysfunction, and then triggers inflammation of the conjunctiva and
epithelial defects [19]. However, the mechanisms of the injury of
ocular surface and accessory organ is still needed to be investigated.