真菌性角膜溃疡前房积脓培养结果的临床分析

目的 探讨真菌性角膜溃疡前房积脓的培养结果与真菌菌种、病程、病理和预后的关系。方法 随机选定拟行穿透角膜移植术的真菌性角膜溃疡且合并前房积脓的患者33例33眼，术中取前房积脓行真菌培养并鉴别菌种，病变角膜片同时做真菌培养和病理检查。结果 全部角膜片真菌培养均阳性。15眼前房积脓培养阳性，其中溃疡穿孔7眼中有6眼阳性。未穿孔26眼中有9眼前房积脓培养阳性。前房积脓培养阳性者12眼为镰刀菌，2眼为梨头霉属，1眼为曲霉菌。病理结果：菌丝穿透后弹力层10眼，8眼前房积脓培养阳性；菌丝未穿透后弹力层16眼，2眼前房积脓培养阳性。结论 真菌性角膜溃疡未合并穿孔者的前房积脓多数为无菌性积脓（65．38％），合并穿孔则前房积脓多为有菌性（85．71％），即使前房积脓为有菌性，通过手术绝大多数可以控制感染保存眼球。

Clinical analysis of hypopyon culture in fungal keratitis

Objective To investigate the correlation among culture results of the hypopyon and the infected fungal strains, pathological examination, diseased course and progonosis in fungal keratitis. Methods 33 cases of severe fungal keralitis which underwent therapeutic penetrating keratoplasty ( PKP) were enrolled in this study. The diseased cornea! hulton were bisected,one half of the corneal button and the hypopyon was taken for culture. Anothor half of the corneal button was taken for pathological study. Results All 33 diseased corneal buttons had positive culture for fungus. 15/33 hypopyon were positive in which 6 eyes had corneal perforation. The fungal spectum is: Fusarium 12 eyes; Ahsldia coerulea 2 eyes; Aspergillus 1 eves. Pathological examination:fungal hypha penetrated the desement membrane in 10 corneal buttons,8 of these cases had a positive culture for fungus. Conclusion Most of the hypopyon in fungal keratitis without perforation are aseptic. If cornea perforate, I he hypopyon is positive in fungal culture. PKP can save the eyes with infected hypopyon.