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。

The therapeutic effects of penetrating keratoplasty on perforated fungal keratitis with corneal perforation

Objective: To evaluate the therapeutic effect of penetrating keratoplasty (PKP) on fungal keratitis with corneal perforation. Methods: 21 cases of fungal keratitis combined with corneal perforation were treated with PKP and were followed up for 6-33 months, average 13.93 months.Results: All the patients preserved their eyes except for one patient. Grafts were transparent in 13 eyes (61.90%). Complications included: fungal recurrence in 4 eyes (19. 05%), recurrent time from 3-14 days after surgery, average 6.25 days; immunological rejection in 8 eyes (38.10%); complicated cataract in 5 eyes (23.81%); secondary glaucoma in 2 eyes (9.52%); posterior synechia of the iris in 6 eyes (28.56%), uninfected ulcer of grafts in 1 eye (4.76%). Conclusions: Sound prognosis can be obtained in perforated fungal keratitis through early surgery and systemic medication.