干燥保存角膜穿透性移植治疗真菌性角膜溃疡

Penetrating keratoplasty for treatment of fungal corneal ulcer by using donor corneas preserved in pure glycerine.

目的 观察以干燥保存角膜片进行穿透性角膜移植术治疗严重的真菌性角膜溃疡的疗效。方法 采用无水甘油保存的角膜片进行穿透性角膜移植 6 8例 ,术后随访 6月～ 5年。结果 6 8例中 ,6 7例经手术治疗后感染控制 ,植片存活。其中 4例术后复发 ,经药物和再手术治愈。术后主要并发症有排异反应、继发性青光眼、大泡性角膜病变等。结论 对药物治疗无效的严重的真菌性角膜溃疡 ,穿透性角膜移植可有效去除病灶 ,控制感染 ,重建眼球 。

Objective To observe the effects of penetrating keratoplasty for treatment of severe fungal corneal ulcer.Methods Penetrating keratoplasty was performed on 68 cases with severe fungal corneal ulcer using donor corneas preserved in pure glycerine.The post operative follow up ranged form 6 months to 5 years.Results In the total 68 cases,the infection was controlled in 67 cases after penetrating keratoplasty,the grafts was survived.In 4 cases the fungal ulcer recurred and then cured after medication and repeated surgery. The main complications were graft rejection,secondary glaucoma and bullous keratopathy.Conclusion To the severe fungal corneal ulcer unresponsive to the maximum medication,penetrating keratoplasty can effectively resolve infection,restore the integrity of the globe and provide support for the optical keratoplasty later.