仿LASEK法建立烟曲霉菌角膜炎动物模型的研究

目的 探讨建立真菌性角膜炎动物模型的新方法.方法 38只新西兰大耳白兔随机分为3组,右眼为实验眼.A组15只兔,采用准分子激光角膜上皮磨镶术(LASEK)制作直径7.0 mm、厚度50μm的角膜上皮瓣,瓣下接种25μL标准烟曲霉菌株(105孢子);B组15只兔,接种前7 d 0.1%地塞米松滴眼液点眼,每日4次,其余步骤同A组;对照组8只兔,以25μL生理盐水代替真菌菌液进行接种.术后采用裂隙灯显微镜、病理组织学检查、角膜真菌培养等方法观察评价角膜真菌感染情况.结果 A、B两组均见典型的真菌性角膜溃疡发生,经真菌培养鉴定为烟曲霉菌.对照组未见有角膜感染.A、B两组接种成功率分别为93.33%和100%,差异无统计学意义(χ2=1.345,P>0.05);B组角膜炎症较A组重、病程长,两组间临床评分差异有统计学意义(接种后3、7、15 d P<0.05,接种后30 d P<0.01).结论 采用LASEK制作角膜上皮瓣能够较理想地建立真菌性角膜炎动物模型.     

兔眼真菌性角膜炎预后观察的实验研究

目的探讨兔眼角膜在感染真菌后的自然病情转归的特点.方法10只新西兰白兔(20眼)作成真菌性角膜炎动物模型,成模后不用任何抗真菌治疗.每天观察兔眼角膜结膜的改变,分别记录成模后不同时间角膜透明度、新生血管和混合充血的情况,同时行菌丝涂片检查.分别于感染后3、7、15、30 d时行病理学和超微结构检查.回顾分析了35例人真菌性角膜炎患病后治疗过程和新生血管形成的时间,并与兔眼进行比较.结果兔眼感染真菌后初期出现角膜溃疡,并伴有前房炎症反应.第7天开始形成角膜新生血管,病情开始转向稳定,15 d后有好转趋势,到第30天时病情明显好转最终达到自愈,仅留下角膜白斑.第30天时真菌菌丝消失.人眼角膜新生血管的形成时间明显晚于兔眼(生存率分析,P＜0.01).结论兔眼真菌性角膜炎的转归与人眼有较大的差异,而且有自愈的趋势,可能与新生血管的长入时间不同,及眼表环境受药物影响有关.从而提示角膜新生血管长入对真菌生长可能有抑制作用;临床上在未明确角膜炎症的性质前,应注意慎用激素和抗生素.     

豚鼠真菌性角膜炎模型的建立及病理观察

目的 探讨理想的真菌性角膜炎动物模型的制作方法,并观察其病理学改变.方法 豚鼠25只(50眼)制作真茵性角膜炎动物模型.分别于接种后2 d、4 d、7 d、14 d过量乙醚麻醉处死豚鼠,取角膜,光镜下观察组织学改变及真菌孢子和茵丝.结果 接种真茵2 d后,可见角膜全层水肿,溃疡形成,干燥致密,粗糙不平,稍隆起.HE染色显示角膜上皮层可见散在孢子及茵丝,且茵丝向基质层长入.随病情进展,溃疡部位角膜上皮及浅基质修复,基质内较多成纤维细胞,细胞走行与基质纤维平行,茵丝平行或斜行于角膜板层生长,有分隔,圆形孢子散在生长,部分标本前房可见茵丝和孢子.结论 利用豚鼠采用剖除角膜上皮,眼睑缝合,茵液滴眼的方法可以成功建立真茵性角膜炎的动物模型.     

丝状真菌所致真菌性角膜炎的临床研究及相关分析

目的 探讨丝状真菌所致真菌性角膜炎的临床研究方法及指导临床治疗的意义。方法 对110例真菌性角膜炎进行10％KOH湿片镜检、大体培养、鉴定培养、药敏试验、病理检查和动物模型实验以指导临床分型及治疗。结果 本组110例中10％KOH湿片镜检可见大分生孢子59例，小分生孢子51例，有隔菌丝101例，无隔菌丝6例，关节状菌丝3例；鉴定培养镰刀菌59株，曲霉菌31株，青霉菌7株，无孢菌5株，头孢子菌2株，链互隔菌2株，附球菌2株，枝顶孢霉菌2株；药敏试验提示氟康唑对丝状菌均呈现耐药性，其他药物对不同的菌属呈现不同的敏感性和耐药性；病理检查可见病变角膜内大量炎细胞及菌丝浸润；15只实验兔角膜划痕接种的动物模型中4例出现角膜真菌感染。结论进行丝状真菌所致真菌性角膜炎的临床研究，对确定真菌在角膜内的生长情况和指导临床分型及选择个性化治疗、减低医疗成本有较大意义。     

白色念珠菌胞外磷脂酶B在兔角膜真菌感染中毒力作用的研究

目的 探讨白色念珠菌胞外磷脂酶B(PLB)在兔真菌性角膜炎中的毒力作用.方法 为实验研究.选用白色念珠菌PLB基因缺失株及其相应母体株,角膜接触镜法建立两种菌株兔角膜感染动物模型,通过对动物模型在2、3、5及8 d不同时间点的临床观察和病变角膜的组织病理学检查,比较两种菌株的毒力;并建立两种菌株孢子与体外培养的兔角膜基质细胞共同孵育体系,通过扫描电镜、酶联免疫吸附实验及流式细胞仪检测,观察两种菌株对细胞的影响,确定PLB的毒力作用机制.结果 两种菌株菌丝在角膜中均呈垂直方式生长;动物模型接种后2 d,两种菌株菌丝在角膜中的浸润深度比较差异有统计学意义(P=0.002);而在3、5及8 d时间点的两种菌株菌丝浸润深度及所有时间点的兔角膜真菌感染的临床表现、角膜炎性反应程度比较差异均无统计学意义(P＞0.05).与单层细胞共同孵育后,两种菌株孢子、菌丝的黏附率、菌丝生成率比较差异无统计学意义(P＞0.05),而破坏穿透细胞膜的菌丝数量比较差异有统计学意义(P=0.009);角膜基质细胞加母体株孢子悬液组培养上清中前列腺素E2(PGE2)的含量为(65 466±5773)pg/ml,较角膜基质细胞加缺失株孢子悬液组培养上清的PGE2含量(18 025±5232)pg/ml明显升高;母体株组、缺失株组及正常对照组细胞膜被破坏细胞的百分比分别为3.02%、2.04%及0.12%;凋亡细胞百分比分别为33.17%、27.56%及1.46%;正常活细胞百分比分别为63.81%、70.40%及98.41%.结论 白色念珠菌胞外PLB在兔角膜感染的整个病理损害中,仅在真菌黏附于角膜刚开始侵袭角膜细胞时有促进菌丝侵入细胞的作用,而在其后角膜炎性反应的病理损害中,并无明显的毒力作用.(中华眼科杂志,2008,44:237-243)     

互隔交链孢霉菌性角膜炎的临床与病原学研究

目的探讨互隔交链孢霉菌性角膜溃疡的临床和实验室特征。方法对真菌性角膜溃疡患者,裂隙灯显微镜下观察临床表现后,角膜刮片作10％KOH湿片、Giemsa染色显微镜检查,真菌菌丝阳性者作真菌培养鉴定,并根据美国国家临床实验室标准化委员会（NCCLS）M38-A方案进行体外药敏试验,同时对患者给予两性霉素B、酮康唑、氟康唑滴眼液治疗,并观察抗真菌药物的疗效。以分离的互隔交链孢霉菌株制作兔真菌性角膜溃疡模型,5d和14d后处死兔,取角膜行真菌培养和组织学检查。结果互隔交链孢霉菌性角膜炎患者均为单眼患病,患者和兔模型的角膜溃疡灶均较浅薄,呈淡灰色,边界模糊。显微镜下角膜刮片可见直且粗大的无色隔膜菌丝,并有大量球形厚垣孢子位于菌丝顶端或相连。分离培养基中该种真菌菌丝为棕色,壁砖墙分隔的深棕色孢子链生于棕色分生孢子梗顶端。体外药物敏感试验显示该种真菌对两性霉素B、酮康唑、氟康唑、伏立康唑、咪康唑、益康唑和特比萘芬敏感,对克霉唑、氟胞嘧啶及伊曲康唑耐药。23例患者除1例手术治愈外,其余22例用两性霉素B、酮康唑、氟康唑联合频繁滴眼治愈,平均治愈时间34d。结论互隔交链孢霉菌性角膜溃疡具有独特的临床和实验室特征,对角膜毒力较低,抗真菌药物联合滴眼可完全治愈。     

共焦显微镜在临床诊断真菌性角膜炎中的应用

目的 评价共焦显微镜在临床诊断真菌性角膜炎中的应用价值。方法 用共焦显微镜对52例临床拟诊为真菌性角膜炎的患者进行检查，同时行角膜病灶刮片培养，对两组结果进行比较。结果 综合病史、临床表现及治疗结果，有45例临床诊断为真菌性角膜炎，其中32例角膜刮片培养到真菌，阳性率为71．11％(32／45)；43例共焦显微镜检查观察到真菌菌丝和／或孢子，阳性率为95．56％(43／45)。结论 共焦显微镜可以在活体角膜上直接观察到真菌菌丝，是一种快速、有效和无损伤的检查方法，对真菌性角膜炎的早期诊断、治疗和研究等具有重要的临床价值。     

氯化十六烷吡啶治疗豚鼠真菌性角膜炎的对比研究

目的 探讨氯化十六烷吡啶滴眼液治疗豚鼠真菌性角膜炎的效果,最终为临床提供理想的抗真菌眼药提供实验依据.方法 健康豚鼠80只,利用改良的制作模型方法复制真茵性角膜炎动物模型,选择感染程度相似的60只豚鼠随机分为5组(A组:空白对照组:B组:氟康唑组;C组:那他霉素组;D组:CYC滴眼液-1组;E组:CYC滴眼液-2组).予药物滴眼,裂隙灯下直接观察、光镜观察各组角膜组织学改变及真菌孢子和茵丝,并对真菌性角膜炎进行临床评分,对比CYC对真茵性角膜病的疗效.结果 打开睑裂后第10天,临床评分:空白对照组为6.667±1.367,氟康唑组为4.833±1.472,那他霉素组为3.167±1.330,CYC-1组为1.500±1.225,CYC-2组为0.667±0.817.CYC组临床评分较其他各组缩小明显,差异有统计学意义(P<0.05).CYC-1组和CYC-2组至打开睑裂第8天左右,溃疡已消失,角膜表面光滑,光镜下几乎不见真菌丝和孢体;而其他3组均可见炎性坏死,坏死组织周围可见大量菌丝和孢子.结论 采用剖除豚鼠角膜上皮、眼睑缝合、菌液滴眼的方法可以成功建立真菌性角膜炎的动物模型;CYC滴眼液较氟康唑和那他霉素能够更有效的治疗豚鼠茄病镰刀菌性角膜溃疡.     

应用激光共焦显微镜诊断真菌性角膜炎的临床研究

目的:应用激光共焦显微镜观察真菌性角膜炎患者图像特点及菌丝和孢子检出率,探讨激光共焦显微镜检查在真菌性角膜炎临床诊断中的意义。方法:对41例41眼经门诊确诊为真菌性角膜炎的患者行角膜激光共焦显微镜检查,观察不同治疗期真菌性角膜炎患者活体角膜各层图像特点。结果:共焦显微镜下真菌性角膜炎患者图像有如下特点:(1)病变部位角膜各层形态结构破坏明显;角膜上皮至基质不同程度水肿;炎细胞浸润;神经结构破坏;基质层结构紊乱,透过度降低;(2)真菌菌丝是本病的特异性诊断依据,不同菌种感染在镜下菌丝有不同的影像学特点;(3)不同病变时期和治疗阶段,图像有很大差异,真菌菌丝的检出并不是诊断本病的唯一依据。结论:激光共焦显微镜检查具有无创、及时等优点,在临床诊断真菌性角膜炎中有重要参考意义,尤其是指导临床早期诊断、合理治疗及评价预后。     

深层板层角膜切除治疗真菌性角膜炎的效果

目的探讨深层板层角膜切除手术联合药物治疗真菌性角膜炎的临床疗效。方法对23例（23眼）直接镜检查到菌丝和／或孢子，确认为真菌性角膜炎者，尽早进行深层板层角膜切除联合抗真菌药物治疗。结果23例痊愈20例视力均有不同程度提高。复发1例、再次手术而治愈。结论真菌性角膜炎在无条件行角膜移植手术时，易尽早行深层板层角膜切除联合药物治疗。     

真菌性角膜炎手术治疗的探讨

目的　探讨真菌性角膜炎的手术疗效。方法　真菌性角膜炎 63例 (63眼 )。 5 6眼施行常规穿透性角膜移植术 ,7眼施行眼前段重建术。术后随访 3～ 19月 ,观察病变转归及手术疗效。结果　术后 41眼角膜移植片保持透明 ;15眼移植片浑浊 ,其中有 7眼发生排斥反应。真菌性角膜炎复发 7眼 ,其中 3眼施行眼内容摘除术。结论　穿透性角膜移植术和眼前段重建术是治疗真菌性角膜炎比较有效的方法。     

贝复舒在治疗真菌性角膜溃疡中的应用

目的观祭治疗具酉性角膜溃疡中应用贝复舒的效果。方法真菌性角膜溃疡患者100例100眼随机分戍治疗组70眼和对照组30眼，治疗组应用贝复舒，对照组应用角膜宁，疗程10d。对比观察2组角膜创面愈合与角膜缘血管翳形成情况。结果治疗组局部创面1周内全部愈合，术后6月3眼形成角膜缘血管翳；对照组1周内22眼愈合，术后6月20眼形成角膜缘血管翳。2者比较差异显著（P〈0．01）。结论贝复舒在治疗真菌性角膜溃疡中具有显著效果。[眼科新进展2005；25（5）：454—455]     

Treatment of fungal keratitis by penetrating keratoplasty

AIM: To study the use of penetrating keratoplasty (PKP) for the treatment of severe fungal keratitis that could not be cured by antifungal medication. METHODS: A retrospective analysis of 108 cases of severe fungal keratitis in which PKP was performed served as the basis for this study. Fungal keratitis was diagnosed by KOH staining of corneal scrapings or by confocal microscopic imaging of the cornea. All patients received a combination of topical and oral antifungal medicines without steroids as the first course of therapy. Patients whose corneal infection was not cured or in whom the infection progressed during antifungal treatment were given a PKP. After surgery, the patients continued to receive antifungal therapy with gradual tapering of the dose over a 1-2 month period. Cyclosporine was used to prevent graft rejection beginning 2 weeks after PKP. Topical steroid only was administered to the patient whose donor graft was over 8.5 mm and with a heavy iris inflammation 2 weeks after PKP. The surgical specimens were used for microbiological evaluation and examined histopathologically. The patients were followed for 6-24 months after PKP. Graft rejection, clarity of the graft, visual acuity, and surgical complications were recorded. RESULTS: Corneal grafts in 86 eyes (79.6%) remained clear during follow up. There was no recurrence of fungal infection and the visual acuity ranged from 40/200 to 20/20. Complications in some patients included recurrent fungal infection in eight eyes (7.4%), corneal graft rejection in 32 eyes (29.6%), secondary glaucoma in two eyes (1.9%), and five eyes (4.6%) developed cataracts. 98 of 108 of the recipient corneas had PAS positive fungal hyphae in tissue sections; 97 of 108 were culture positive for various fungi, including Fusarium (63), Aspergillus (14), Candida (9), Penicillium (4), and seven cases in which septate hyphae were seen but identification of the organism was not conclusive. CONCLUSIONS: PKP is an effective treatment for fungal keratitis that does not respond to antifungal medication. Early surgical intervention before the disease becomes advanced is recommended. It is critical that the surgical procedure remove the infected tissue in its entirety in order to effect a cure.     

Hydrogel contact lens-induced Pseudomonas keratitis in a rabbit model

Unused soft contact lenses (SCL) containing 38.6% water (polymacon) and 70% water (lidofilcon A) were exposed to Pseudomonas aeruginosa (10(8) CFU/ml) for 60 min and washed. The contaminated lenses were used on rabbit eyes under the following conditions: for 1 h on a scratched corneal epithelium (16 eyes, four infected), for 24 h on normal cornea (eight eyes, none infected), and for 7 days on normal cornea (eight eyes, three bacterial infections and two noninfected epithelial defects). A control group of rabbits used an uncontaminated lens for 7 days (eight eyes, four noninfected epithelial defects). The control group and groups that wore contaminated lenses for 24 h and 7 days underwent tarsorrhaphy to keep the contact lens in place. In addition, three drops of the bacterial suspension were instilled in eyes with normal corneal epithelium (eight eyes, none infected) and scratched corneal epithelium (16 eyes, 13 infected). Results suggest that Pseudomonas-contaminated SCL give rise to keratitis only on an injured corneal epithelium and that a bacterial suspension is more pathogenic to the rabbit cornea than is a similar amount of bacteria on an SCL.     

光学性全厚板层角膜移植术治疗真菌性角膜炎的初步探讨

目的初步探讨完全钝性分离的光学性全厚板层角膜移植术治疗真菌性角膜炎的可行性、安全性和增视效果。方法采用前瞻性非对照研究,对临床确诊为真菌性角膜炎且常规抗真菌药物治疗无效的患者行活体激光共焦显微镜检查．对其中明确菌丝未累及角膜深基质及后弹力层的21例患者（21眼）行完全钝性分离的光学性全厚板层角膜移植术。术后第1周、第1个月、第3个月、第6个月、第12个月和第18个月常规随访,观察角膜植片上皮愈合情况、有无真菌复发、免疫排斥反应、移植片透明度和最佳矫正视力等;术后第6个月和第12个月复查角膜内皮细胞密度。结果术前激光共焦显微镜检查。21只患眼均找到真菌菌丝,未见菌丝累及角膜深基质及后弹力层：术中无一例因后弹力层穿破而改行穿透性角膜移植术;仅1例在术后2周内出现真菌复发,复发率为4．76％。其余20例平均随访（14±6）个月,角膜植片均透明,治愈率为95．24％。术后第6个月,有14例术眼最佳矫正视力≥4．5,其中5例≥4．8。术后第6个月,平均角膜内皮细胞密度为（2296±368）个／mm^2（1025～3491个／mm^2）;术后第12个月为（2337±357）个／mm^2（1016～3380个／mm^2）。结论光学性全厚板层角膜移植术是一种治疗真菌性角膜炎的有效手段．激光共焦显微镜有助于真菌的诊断和真菌浸润深度的判断．完全钝性分离的方法减少了前房穿孔率,提高了手术的成功率。     

穿透性角膜移植治疗真菌性角膜溃疡穿孔的疗效评价

目的:评价穿透性角膜移植术（PKP）治疗真菌性角膜渍疡穿孔的疗效。方法:采用新鲜供体角膜19只、甘油冷冻保存的供体角膜2只,对本院收治的21例真菌性角膜溃疡穿孔患者行PKP治疗,随访6～33月,平均13.93月。结果:术后植片透明13眼,植片透明率为61.90％。除一眼眼球萎缩外,其余患者均保存了眼球。术后:真菌复发4眼（19.05％）;免疫排斥反应8眼（38.10％）;并发性白内障5眼（23.81％）;继发性青光眼2眼（9.52％）;虹膜后粘伴瞳孔改变6眼（28.56％）;植片无菌性溃疡1眼（4.76％）。结论:真菌性角膜溃疡穿孔的病例,通过合理用药和及时手术,完全可以获得较好疗效,但是术后并发症较多应该加强随访。     

Sensitivity and specificity of confocal scan in the diagnosis of infectious keratitis

PURPOSE: To compare the sensitivity and specificity of confocal scan with the results of corneal and/or contact lens case smear and culture in the diagnosis of infectious keratitis. METHODS: This was a diagnostic test study. Confocal scan and corneal and/or contact lens case smear and culture were performed in all patients with a clinical diagnosis of infectious keratitis at Labbafinejad Medical Center from 2004 to 2006. RESULTS: A total of 133 eyes of 133 patients with a mean age of 48.0 +/- 22.6 years (range, 9-83 years) were included in the study. Sixty-nine (51.9%) cases were men, and 64 (48.1%) were women. Twenty-eight cases (21%) were contact lens wearers; history of trauma and previous ocular surgery was present in 21% and 38.3%, respectively. Corneal and/or contact lens case smear and culture were positive in 71 eyes (53.4%), including 40 cases of bacterial, 16 cases of fungal, and 15 cases of acanthamoeba infection. Confocal scan was positive in 50 cases (37.6%), which revealed hyphae-like structures in 27 cases and cyst and/or trophozoite-like structures in 23 cases. The sensitivity and specificity of confocal scans were 100% and 84% for the diagnosis of acanthamoeba keratitis versus 94% and 78% for fungal keratitis, respectively. CONCLUSIONS: In vivo corneal confocal scan is a rapid noninvasive tool for the diagnosis of acanthamoeba and fungal keratitis with high sensitivity and specificity compared with smear and culture. It may also be helpful in excluding fungal or acanthamoeba-like structures in cases with negative bacteriologic results and in early bacterial keratitis before clarification of microbiologic results.     

A retrospective analysis of infection after corneal transplantation

PURPOSE: We studied retrospectively the background of postoperative infection after corneal transplantation. METHODS: We reviewed the records of 753 eyes that had undergone corneal transplantation at Kyoto Prefectural University of Medicine or the Baptist Eye Clinic over a period of 6 years from April 1994 to March 2000. Patients who developed microbial keratitis after corneal transplantation were evaluated for the incidence of infection, age, the interval between transplantation and infection, microbiological etiology, the use of topical steroids, therapy, and complications. RESULTS: Follow-up after keratoplasty averaged 43.2+/-25.6 months (mean+/-standard deviation). Among 753 eyes examined, microbial keratitis developed in 27 eyes (3.6%), 14 eyes had bacterial, and 13 had fungal infections. The ages at presentation were 51.4+/-21.5 years for bacterial infections, and 66.5+/-11.1 for fungal infections. The time intervals between transplantation and the onset of infection averaged 7.8+/-7.9 months for bacterial infections, and 24.2+/-17.2 for fungal infections. Infections in 7 (50.0%) of the bacterial eyes were caused by methicillin-resistant Staphylococcus aureus (MRSA) or epidermidis (MRSE), and 9 (69.2%) of the fungal infections by yeast type fungus (8 were Candida species). At onset of keratitis, 3 (21.4%) of the bacterial eyes and 6 (46.2%) of the fungal eyes were treated with fluorometholone, and 11 (78.6%) of the bacterial eyes and 7 (53.8%) of the fungal eyes were treated with betamethazone or dexamethasone. The treatment duration until the focus of disappeared was 32.8+/-19.7 days for bacterial eyes, and 74.8+/-56.3 for fungal eyes. Major complications associated with infection included corneal perforation in 2 eyes of both the bacterial (14.3%) and fungal (15.4%) eyes, graft rejection in 4 (28.6%) bacterial eyes and 1 (7.7%) fungal eye, there was no recurrence of infection in the bacterial eyes but there were 3 (23.1%) cases of recurrence in the fungal eyes. CONCLUSIONS: Infection after corneal transplantation is opportunistic. Fungal infections occurred later than bacterial infections. Also in fungal infections, the mean age at presentation was higher and the recurrence of infection was more frequent.     

角膜溃疡清创联合羊膜覆盖术及药物治疗真菌性角膜炎的临床疗效

背景 真菌性角膜炎发病率高,临床上因缺乏高效、低毒和广谱的抗真菌药物,治疗较为棘手.穿透角膜移植是目前有效的治疗方法,但角膜供体缺乏限制了该手术的开展.寻求经济、有效的治疗方法具有重要临床意义. 目的 比较角膜溃疡清创联合羊膜覆盖术及药物治疗与角膜溃疡清创联合药物治疗对真菌性角膜炎的临床治疗效果.方法 采用前瞻性病例对照研究方法,收集2001年1月至2013年1月在青岛大学附属医院确诊为真菌性角膜炎的患者210例210眼,随机数字表法分为观察组109例和对照组1 01例,2个组患者基线特征匹配.观察组患者采用角膜溃疡清创联合羊膜覆盖术及药物治疗法,对照组应用角膜溃疡清创联合药物治疗法,对2个组间患者的治疗效果、平均视力和平均疗程进行比较. 结果 观察组轻、中、重度真菌性角膜炎患者的有效率分别为100.00％、90.41％、77.78％;对照组分别为52.38％、80.00％、25.00％,差异均有统计学意义（U=2.211、2.214、2.356,P＜0.05）;观察组治疗总有效率为91.09％,对照组为75.23％,差异有统计学意义（U=3.040,P=0.002）.观察组治疗的平均视力为0.44±0.04,明显好于对照组的0.22±0.03,差异有统计学意义（t=2.225,P＜0.05）;观察组治疗疗程平均为（22.4±1.8）d,明显短于对照组的（33.2±2.4）d,差异有统计学意义（t=2.097,P＜0.05）.结论 角膜溃疡清创联合羊膜覆盖术和药物治疗是治疗真菌性角膜溃疡的有效方法,有助于缩短疗程,提高治疗效率,明显优于角膜溃疡清创联合药物治疗法.