带巩膜的全角膜移植治疗严重真菌性角膜感染

Therapeutic sclerokeratoplasty in the treatment of severe fungal keratitis

目的 报告带巩膜环全角膜移植术治疗严重真菌感染的临床疗效。方法 对 1999 6～2 0 0 1 9在我院因真菌性角膜炎接受带巩膜环的全角膜移植治疗的 8例患者进行随访 ,其中 ,男 5例 ,女 3例 ,随访 3月～ 3年 ,平均 11 6月。对该术式的适应症、手术技巧、术后并发症及疗效进行评价。结果 术后所有患者感染均得到控制 ,保存了眼球。最后一次随访植片透明 7例 ,视力 :0 1～0 3有 4例 ;0 3～ 0 5有 2例 ;1 0有 1例。术后并发症有 :1周内前房出血 5例 ,1～ 2周内均自行吸收 ;2周内前房消失 3例 ,2～ 3周后自行恢复正常 ;内皮型免疫排斥反应 5例 ,但无因排斥导致植片失代偿 ;并发性白内障 3例。结论 对严重的全角膜真菌感染行带巩膜环的全角膜移植术是保存眼球、获得有用视力的有效方法。

Objective To report the results of therapeutic sclerokeratoplasty in the treatment of severe fungal keratitis.Methods 8 cases of refractory fungal keratitis which infected total cornea were treated by sclerokeratoplasty and were followed up for 3 months to 3 years.Surgical techniques,complications,graft rejection and vision were evaluated.Results After sclerokeratoplasty,fungal infection was eliminated in 8 of 8 eyes,and all the eyes maintained the structural integrity of the globe.Postoperative complication included transient shallow anterior chamber,hyphema at the early stage.Allograft immune rejection episodes occurred in 5 of 8 cases and no graft failure during follow up period.Complicated cataract was found in 3 cases.4 eyes has a visual acuity of 0.1～0.3,2 eyes has 0.3～0.5,1 eye has 1.0.Conclusions Sclerokeratoplasty is a valuable method to preserve the global and allow useful vision for refractory severe fungal keratitis.