角膜移植治疗严重真菌性角膜溃疡

Clinical study of therapeutic keratoplasty for treatment of serious fungal corneal ulcer.

目的评价角膜移植治疗严重真菌性角膜溃疡的临床效果及影响因素。方法采用穿透性或板层角膜移植治疗穿孔及几近穿孔的真菌性角膜溃疡53人（53眼），临床观察4～40月。结果50眼角膜植片存活，溃疡治愈率94．34％．27眼角膜植片透明，透明率、增视率均为54．00％。结论对药物治疗无效的严重真菌性角膜溃疡、穿孔者及时行治疗性角膜移植术可以治愈感染，挽救眼球，甚至恢复有用视力。

Objective To evaluate the effects of therapeutic keratoplasty in treatment of serious fungal corneal ulcer. Methods Therapeutic keratoplasty was performed on 53 eyes of 53 cases of fungal corneal ulcer with corneal dcscemetoceles and perforations. All patients were followed up for 4 to 40 months after surgery. Results 50 cases （94.34%） resulted in successful resolution of fungal infection, grafts of 27 cases （54.00%） remained clear. Conclusions Therapeutic keratoplasty is valuable in the management of fungal corneal ulcer and corneal perforation that does not respond to antifungal medicines. It can succeed curing fungal infection,saving eyeball, achieving a useful visual acuity.