伏立康唑治疗浅中层真菌性角膜溃疡的疗效观察

Clinical outcomes of voriconazole in treatment for shallow to middle fungal keratitis

目的：观察局部应用伏立康唑治疗浅中层真菌性角膜溃疡的临床效果。方法回顾性分析2012年7月至2013年11月间于山东省眼科医院诊治的59例（59只眼）溃疡直径在2～6 mm，经氟康唑治疗效果欠佳，改用伏立康唑治疗的浅中层真菌性角膜溃疡患者资料，分析其临床特征、治疗方法及愈后，观察伏立康唑在治疗浅中层真菌性角膜溃疡的临床效果。结果59例患者中经伏立康唑药物治愈的患者22例（37．29％），主要是溃疡直径在（3．800±1．196） mm，溃疡浸润深度/角膜厚度为0．292±0．111的真菌性角膜溃疡患者可通过单纯伏立康唑药物治疗得到较佳的治疗效果。结论对于部分浅中层真菌性角膜溃疡患者，在临床应用氟康唑效果欠佳的情况下可通过应用伏立康唑治疗，对30％以上的患者仍能得到较佳治疗效果。

Objective To observe the clinical effects of topical voriconazole on the treatment of shallow to middle fungal keratitis .Methods We have reviewed 59 patients with shallow to middle fungal keratitis （ FK） that underwent ther-apy at the Shandong Eye Hospital from July 2012 to November 2013.The ulcer diameter ranged from 2 to 6 mm.All the patients were treated with fluconazole eye drops initially .In cases which ulcer areas were not reduced with fluconazole treat-ment, voriconazole solution （10 mg/ml） was used to replace fluconazole .The clinical features, therapeutic effects and prognosis were summarized.Results In 59 patients, twenty-two had been cured by voriconazole （37.29%）.The average ulcer diameter was 3.800 ±1.196 mm and the ulcers＆#39;average infiltrating depth was 0.292 ±0.111 mm.Conclusions For patients with shallow to middle fungal corneal ulcer that failed fluconazole treatment , voriconazole is an effective alternative that can achieve more than 30%cure rate.