角膜移植治疗真菌性角膜炎180例临床分析

The clinical study of treating fungal keratitis with keratoplasty

目的 探讨角膜移植术治疗真菌性角膜炎的临床效果。方法 对临床确诊的 180例 (180只眼 )真菌性角膜炎患者 ,32例行部分板层角膜移植术 (L KP) ,14 8例行穿透性角膜移植术 (PKP)。结果 172例 (172只眼 )感染控制 ,治愈率为 95 .5 5 %。随访 2～ 2 4个月 ,32例 L KP患者 2 8例植片透明 ,矫正视力 0 .2～ 0 .8,10 9例 PKP患者植片透明 ,矫正视力 0 .0 5～ 1.0 ,两组病例矫正视力比较 ,无显著性差异 (P >0 .0 5 )。 PKP术后的并发症发生率明显高于 L KP。结论 角膜移植术是治疗真菌性角膜炎的有效方法 ,表浅型真菌性角膜炎 L KP术是可行的 。

Objective To investigate clnical effect of treatment of fungal keratitis with lamellar keratoplasty(LKP) and penetrating keratoplasty(PKP).Methods 32 eyes of 32 cases of fungal keratitis were treated with lamellar keratoplasty,and 148 eyes of 148 cases with penetrating keratoplasty.Resuts 172 eyes(95.55%) resulted in successful resolution of fungal infection and were followed up for 2～24 months.Grafts were transparent in 28 eyes of LKP and in 109 eyes of PKP.The correction visual acuity were 0.2～0.8 in LKP groups,and 0.05～1.0 in PKP groups.There was no statistically significant difference between the LKP groups and the PKP gruops in correction visual acuity (P>0.05).Conclusion Keratoplasty is an effective method to treat fungal keratitis.LKP is a reliable way in treating fungal keratitis when the lesion lies in superficial or middle layer,and the complications were lower than PKP.