真菌性角膜溃疡穿孔行结膜瓣覆盖的疗效分析

Efficacy of conjunctival flap covering in the treatment for fungal keratitis ulcers

目的分析真菌性角膜溃疡穿孔（穿孔〈2.0 mm）行结膜瓣覆盖术后的治疗效果。方法回顾性分析2009年1月到2013年9月在我院患者行结膜瓣覆盖术,并有完整记录的患者127例（127只眼）。统计手术前后视力变化、前房深度及溃疡复发的发生率。结果术后视力提高31例（24%）,不变78例（61%）,下降18例（14%）;术后5-9天前房深度正常,术中27例、术后3例行前房注气重建前房;术后2年治愈101例（94.3%）,溃疡复发6例（3%）。结论羊膜覆盖术可作为真菌性角膜溃疡穿孔（穿孔〈2.0 mm）保住眼球的一种有效、简便、经济的手术方法。

Objective To evaluate the efficacy of conjunctival flap covering in the treatment for fungal keratitis ulcers with perforation radius 2. 0 mm. Methods A retrospective study was done to investigate 127 patients（127 eyes）who received conjunctival flap covering surgeries between January 2009 and September 2013 for the treatment of corneal ulcers resulted from fungal infection. Visual acuity changes,anterior chamber depth,and the recurrence rate of fungal infections were examined and analyzed. Results acuity improved in 31 cases（ 24%）,remained unchanged in 78 cases（61%）,and decreased in 18 cases（14%）. Anterior chamber depth became normal within 5 -7 days after the surgery.Gas injection to rebuild anterior chamber was needed during surgery in 27 patients and after surgery in 3 patients. After 2years of follow - up,101 patients were cured（94. 3%）,while recurrent ulcers were found in only 6 patients（3%）. Conclusion Conjunctival flap covering is an effective treatment for fungal keratitisulcers with perforation radius〈 2. 0 mm