摘要
目的:探讨角膜胶原交联术在治疗真菌性角膜溃疡的可行性及临床疗效。方法:回顾性系列病例研究。收集2011年11月至2017年12月于厦门大学附属厦门眼科中心住院治疗的真菌性角膜溃疡患者82例(82眼),在联合用药无效或效果不佳的情况下行角膜胶原交联术。术后观察指标包括患者的主观症状、角膜溃疡愈合情况、视力恢复情况,共聚焦显微镜检查角膜溃疡情况。结果:所有患者术后观察时间为6个月至3年,角膜溃疡逐渐愈合形成不同程度瘢痕71例(愈合率87%),其中视力提高且不需要再次手术患者52例;病情仍然进一步加重,急性期行角膜移植手术患者8例,急性期行自体结膜瓣遮盖术患者1例;溃疡稳定但再次复发加重并行角膜移植术患者2例。结论:角膜胶原交联术是真菌性角膜溃疡新的治疗方法,且其联合药物治疗真菌性角膜溃疡简单、安全、有效。
Objective:To evaluate whether corneal collagen cross-linking improves the outcome of fungal keratitis.Methods:This was a retrospective clinical study.Patients(n=82)with fungal infected eyes were treated at Affiliated Xiamen Eye Center of Xiamen University,from November 2011 to December 2017.Corneal cross-linking was performed using the standard protocol after a multi-antifungal drug treatment failed to resolve the infection in patients.Main outcome measures:Clinical symptoms and corneal healing were examined using a slit lamp biomicroscope and an in vivo laser confocal microscope.Visual acuity improvement was also evaluated.Results:After 6 months to 3 years of follow-up,corneal scars eventually developed in 71 of 82 eyes.In 52 of 82 eyes,visual acuity improved.However,corneal melting was exacerbated and uncontrolled in 8 patients who immediately underwent corneal transplant surgery.In one patient,self-conjunctival transplantation was performed,and two others received a therapeutic corneal transplant due to recurrent inflammation and melting.Conclusions:Our results demonstrate that corneal collagen cross-linking is an effective procedure to manage patients afflicted with fungal keratitis.
作者
罗顺荣
吴护平
林志荣
Shunrong Luo;Huping Wu;Zhirong Lin(Affiliated Xiamen Eye Center of Xiamen University,Xiamen 361001,China)
出处
《中华眼视光学与视觉科学杂志》
CAS
CSCD
2020年第8期568-574,共7页
Chinese Journal Of Optometry Ophthalmology And Visual Science
基金
国家自然科学基金(81570815、81570816)
福建省自然科学基金(2015D013)
福建省医学创新课题项目(2014-CXB-50)
福建省卫生计生青年科研课题(2017-2-117)
厦门市科技惠民计划(3502Z20174003)
厦门市科技局重大科技创新平台项目(2013S0226)。
