前房冲洗及结膜瓣掩盖治疗化脓性角膜炎

目的探讨伴有前房积脓的化脓性角膜溃疡行前房冲洗联合结膜瓣掩盖术的效果。方法12例药物治疗无效的化脓性角膜溃疡，在处理溃疡面后，以角膜穿刺刀在颞下及鼻下方角膜缘处做两个相对的穿刺1：3，以8U／mL庆大霉素液冲洗前房。前房积脓冲洗干净后，制作桥状结膜瓣，覆盖于溃疡面上，以10—0尼龙缝线固定。前房充气，加压包扎。术后继续用药，10天拆线，14天剪除结膜瓣两端。结果覆盖的结膜瓣萎缩变白形成角膜白斑，周边角膜透明，前房积脓消失。术后视力增加，视力最好者达0．3。结论前房冲洗联合结膜瓣掩盖术治疗药物不能控制的化脓性角膜溃疡，效果良好，并为二期角膜移植创造了条件。此法操作简便，效果确切，不需特殊材料。

Treatment of purulent corneal ulcer with anterior chamber irrigation and conjunctival flap masking

Objective To explore the effect of anterior chamber irrigation combined with conjunctival flap masking for purulent corneal ulcer. Methods Twelve purulent corneal ulcer patients with little effects of medication were recruited for the study. Two opposing puncture opening were made with cornea paracentesis knife at the limbus after the surface of ulcer was treated, then the anterior chamber was washed with 8U/mL gentamycin. After the oculUs purulentus was washed out, brideglike conjunctival flap was made to cover the ulcer, and fixed with 10-0 nylon suture. Medication contiued to use after surgery, stitches were taken out after ten days, and two sides of conjunctival flap were cut after 14 days. Results The conjunctival flap become leucoma, peripheral cornea was transparent, and oculus purulentus disappeared. The acuity of vision increased after surgery, and the best vison was 0.3. Conclusion Anterior chamber irrigation combined with conjunctival flap masking for purulent corneal ulcer is effective.