病灶切除联合结膜移植治疗真菌性角膜溃疡

Excision of focus combined with conjunctival transplantation for treating fungal corneal ulcer.

目的 探讨病灶切除联合结膜移植术治疗真菌性角膜溃疡的适应症及临床效果。方法 选择药物治疗无效病灶位于角膜中浅层的真菌性角膜溃疡患者 2 8例 ,彻底切除病灶 ,依病灶大小自患眼角膜上方切取游离结膜瓣或带蒂结膜瓣缝合于植床。结果 治愈 2 7例 (96 43 % ) ,复发 1例 (3 5 7% ) ,术后 3月矫正视力 0 0 2～ 0 0 5者 6例 ;0 1～ 0 2者 15例 ;≥ 0 3者 8例。结论 该手术治疗真菌性角膜溃疡疗效肯定 ,对于中浅层溃疡 。

Objective To investigate the indication and effect of excising the focus combined with conjunctival transplantation for treatment of fungal corneal ulcer.Methods 28 cases with the focus of medium or superficial layer of corneal were selected.The focus was thoroughly removed,free conjunctival flap of pedicle conjunctival flap was cut from above the cornea according to the size of focus,and were sutured to the graft bed.Results 27 cases (96.4%) were cured,one case (3.57%) was recurred.The corrected visual acuity on 3 months postoperatively was 0.02～0.05 in 6 cases,0.1～0.2 in 15 cases,and 0.3 or better in 8 cases.Conclusions The effect of fungal corneal ulcer treated with excision of focus combined with conjunctival transplantation is satisfactory,it can substitute the corneal lamellar transplantation for the middow or shallow corneal ulcer.