角膜板层切除联合羊膜移植及结膜瓣覆盖术治疗真菌性角膜炎的效果

目的观察角膜板层切除联合羊膜移植及结膜瓣覆盖术治疗真菌性角膜炎的临床效果。方法病灶区角膜板层切除，保存或新鲜羊膜氟康唑注射液内浸泡半小时后双层或多层覆盖角膜植床，取上方桥状或蒂状球结膜瓣覆盖病灶区连同羊膜一并缝合固定，1个月后在表面麻醉下剪断结膜蒂，并拆线。结果19例（19眼）角膜炎症全部控制，拆线时羊膜吸收或部分吸收，角结膜愈合。6个月～3年随访，视力数指～0．1者8眼，0．2～0．5者11眼。所有移植的结膜瓣均为半透明愈合，血管萎缩，大部分角膜表面凹陷明显变浅。结论本手术方法为一种治疗真菌性角膜炎的有效方法之一。

Treatment of fungal keratitis by corneal iameilar resection combined with amniotic membrane tranplantion and conjunctival flap covering

Objective To evaluate the effect of corneal lamellar resection plus amiotic membrane (AM) transplantation combind with conjunctival flap covering for fungal keratitis. Methods The corneal lamella of focus was resected and covered with preserved or fresh amniotic membrane which was immersed in Fluconazole injection solution for half an hour and conjunctival flap. The AM and conjunctival flap were fixed up by suture. The conjunctival pedicle was snipped under surface anaesthesia and removed the suture after one motth. Results Keratitis of 19 eyes was controled, AM was totally or partly absorbed. Conjunctiva and cornea healed up when suture was removed. Following-up 6 months to 3 years, visual acuities of 8 eyes were CF ～ 0.1,11 eyes were 0.2 ～ 0.5. All of conjunctival flaps were translucent in healing up. Blood vessels were atrophic, and most hollows of corneal surface became shallow. Conclusions This measure is one of efficient ways for treatment of fungal keratitis.