改良结膜瓣遮盖术治疗重症真菌性角膜溃疡的临床研究

目的探讨应用改良结膜瓣遮盖术治疗重症真菌性角膜溃疡的临床效果。方法选择感染基本控制的重症真菌性角膜溃疡58例（58眼），其中角膜穿孔10例。手术中角膜溃疡面清创，4％碘酊烧灼溃疡面，在临近角膜溃疡处做带眼球筋膜囊组织的单蒂结膜瓣遮盖于表面，间断固定缝合。结果55例术后一次成功，3例结膜瓣溶解脱落，手术一次成功率94．83％。其中10例角膜穿孔眼手术均一次成功，感染全部控制，但是有2眼术后发生继发性青光眼。结论改良结膜瓣遮盖手术在治疗重症真菌性角膜溃疡中能有效地控制感染，保存眼球，尤其是对穿孔或近穿孔而无条件进行角膜移植的患者可控制病情，为下一步复明手术打下基础。

Clinical effect study of the treatment of Modified conjunctival flap microsurgery to the severe fungal corneal ulcer.

Objective To study the treatment of the modified conjunctival flap microsurgery （m-CFM） to the severe fungal corneal ulcer. Methods The m-CFMs were operated to the 58 patients with fungal corneal ulcer, include 10 patients with perforated corneal ulcer. Before surgeries, it should be done as possible as we could to control the infection. Then while surgery, the ulcers were cleared, and the conjunctival flap and the Tenon＇ s capsule were sew on the cornea to envelope the ulcer in file. Results The infections in 55 eyes were controlled by one surgery, as the same time, the flaps on other 3 eyes were dissolved . The surgeries to 10 eyes with perforation were all succeed, though 2 of them catch a secondary glaucoma. Conclusion The infection of the fungal cornea ulcer was be controlled by m-CFM, and the eyes were protected. The m-CFM especially could be done to the cornea infective ulcer with perforation or nearly perforation when the cornea transplantation couldnt be done.