伏立康唑治疗中重度真菌性角膜溃疡的初步观察

目的 观察伏立康唑全身及眼部用药治疗中、重度真菌性角膜溃疡的临床效果.方法 回顾分析24例(24只眼)真菌性角膜溃疡患者的治疗经过和结果.其中中度角膜溃疡17例、重度7例.所有患者均用伏立康唑静脉滴注,首次6mg/kg,次日4mg/kg,均为12h1次;1%伏立康唑眼液点眼,每1h1次;前房积脓冲洗联合伏立康唑前房注药;局部清创,每1～2日1次,最后根据病情选择自体改良结膜瓣遮盖术、治疗性角膜移植手术等.结果 24只眼中有21只眼(87.5%)达到临床治愈,1只眼好转,2只眼无效.无效的2只眼中有1例行眼内容剜除术,1例行角膜移植手术.未出现严重药物不良反应.结论 伏立康唑是有效、安全的治疗真菌性角膜溃疡的药物,值得临床推广应用.

Abstract：

Objective To investigate the effect of voriconazole in the systemic and local medication treatment of moderate and severe fungal corneal ulcers.Methods The treatments and results of 24 patients (24 eyes)with fungal corneal ulcers were retrospective analyzed.Of 17 cases were with moderate corneal ulcers and 7 with severe corneal ulcers.All patients were treated with intravenous voriconazole,6mg/kg for the first time,4 mg/kg on day 2,once per 12 hours; 1% of the voriconazole eye drops,once per 1 hour; hypopyon was washed out with anterior chamber injection of voriconazole,with local debridement,once per 1 to 2 days.Finally,the conjunctival flap covering surgery or the corneal transplant surgery was chosen based on the condition of patients.Results In 21 of 24 eyes(87.5%)achieved clinical cure,one eye improved and two invalid;1 of the 2 invalid eyes received eye evisceration surgery,the other received a corneal transplant surgery,with no serious adverse drug reactions.Conclusions Voriconazole is a safe,effective medicine in treating fungal corneal ulcers,and it is worthy of clinical application.

Preliminary observations of voriconazole treatment of moderate and severe fungal corneal ulcer

Objective To investigate the effect of voriconazole in the systemic and local medication treatment of moderate and severe fungal corneal ulcers.Methods The treatments and results of 24 patients (24 eyes)with fungal corneal ulcers were retrospective analyzed.Of 17 cases were with moderate corneal ulcers and 7 with severe corneal ulcers.All patients were treated with intravenous voriconazole,6mg/kg for the first time,4 mg/kg on day 2,once per 12 hours; 1% of the voriconazole eye drops,once per 1 hour; hypopyon was washed out with anterior chamber injection of voriconazole,with local debridement,once per 1 to 2 days.Finally,the conjunctival flap covering surgery or the corneal transplant surgery was chosen based on the condition of patients.Results In 21 of 24 eyes(87.5%)achieved clinical cure,one eye improved and two invalid;1 of the 2 invalid eyes received eye evisceration surgery,the other received a corneal transplant surgery,with no serious adverse drug reactions.Conclusions Voriconazole is a safe,effective medicine in treating fungal corneal ulcers,and it is worthy of clinical application.