目的：通过为青光眼患者提供安全、有效、经济、合理的规范化药学服务，探讨药物重整在青光眼患者中的临床应用价值，并评估药物重整服务在眼科专科用药方面的可行性。方法：采用前瞻性研究设计，纳入武汉大学附属爱尔眼科医院2023年8月-2024年1月青光眼住院患者308例, 临床药师通过收集用药史、医嘱审核、用药偏差纠正、用药教育等多种方式实施药物重整服务。结果：在308例患者中，104例患者存在需重整的用药问题，重整率为33.8%，重整医嘱共198条，在这些重整医嘱中，用药依从性问题占57.0%，用药安全性问题占18.1%，用药差错占24.9%。经过药物重整，患者用药依从性提升至95.1%(χ²=27.210，P<0.05)，安全性问题降至1.3%(χ²=22.565，P<0.05)，用药差错率降至1.9%(χ²=26.251，P<0.05)。结论：药物重整可提高青光眼患者的用药合理性及依从性，是保障患者用药安全、合理的有效药学服务手段。

Objective: To introduce medication reconciliation (MR) services for glaucoma patients, with the aim of delivering safe, effective, and cost-effective pharmaceutical care. This study also evaluates the clinical value of MR in glaucoma management and assesses its feasibility within ophthalmic specialized medication practices. Methods: In this prospective study, 308 hospitalized glaucoma patients were enrolled between August 2023 and January 2024. Clinical pharmacists conducted medication reconciliation using standardized procedures, which encompassed comprehensive medication history collection, medication order review, correction of discrepancies, and structured discharge counseling. Results: Among the 308 patients, MR interventions was required in 104 cases (33.80%), identifying 198 medication related issues. Of these, 57.0% pertained to medication adherence problems, 18.1% involved medication safety concerns, and 24.9% related to medication appropriateness. Following medication reconciliation, medication adherence improved to 95.1% (χ²=27.210, P<0.05), the incidence of adverse drug reactions declined to 1.3% (χ²=22.565, P<0.05), and medication appropriateness issues decreased to 1.9% (χ²=26.251, P<0.05). Conclusions: MR significantly enhances medication appropriateness and adherence in glaucoma management. This evidence-based pharmaceutical care model effectively ensures medication safety and therapeutic efficacy, offering practical insights for extending MR to other chronic ophthalmic conditions.