角膜清创联合结膜瓣遮盖术治疗真菌性角膜溃疡

目的：观察角膜清创联合结膜瓣遮盖术治疗真菌性角膜溃疡的临床疗效。 方法：对2011-01/11收治的30例30眼真菌性角膜溃疡患者行患眼角膜清创联合结膜瓣遮盖术治疗，术后继续药物治疗。 结果：17例17眼1次手术,结膜瓣遮盖良好,角膜溃疡治愈; 7例7眼1次手术,1wk内结膜瓣脱落或溶解,继续用药10d~2mo角膜溃疡治愈;2例2眼1次手术,1wk内结膜瓣脱落或溶解,经2次手术,结膜瓣遮盖良好,角膜溃疡治愈;4例4眼1次手术,1wk内结膜瓣脱落或溶解,治疗过程中角膜溃疡穿孔,而行角膜移植术。30例30眼通过结膜瓣遮盖总治愈26例26眼,治愈率87%。 结论：角膜清创联合结膜瓣遮盖术是一种治疗真菌性角膜溃疡的有效方法,适合基层医院,可以尽可能挽救眼球,保留残存视力,为进一步行角膜移植术提供条件。

Corneal ulcer debridement combined with conjunctiva flap covering in treatment of fungal corneal ulcer

AIM: To study the clinical curative effect of corneal ulcer debridement combined with conjunctiva flap covering surgery in treatment of fungal corneal ulcer. METHODS: From January 2011 to November 2011,30 cases (30 eyes) with fungal corneal ulcer were treated with removal of the necrotic corneal tissue combined with conjunctiva flap covering surgery. RESULTS: Postoperatively, the corneal ulcer in 17 cases(17 eyes) was cured after one surgery, and whose conjunctiva flaps were good; the corneal ulcer in 7 cases (7 eyes) was cured by drug in 10 days-2 months after one surgery, and whose conjunctiva flaps were desquamated in 1 week; the corneal ulcer in 2 cases(2 eyes) was cured after treated again by conjunctiva flap covering surgery after the conjunctiva flap was desquamated in 1 week; the corneal ulcer in 4 eyes was not cured after one surgery whose conjunctiva flaps were desquamated in 1 week, because of corneal perforation, they had to be performed by keratoplasty. 26 cases (26 eyes) were cured by conjunctiva flap covering surgery in 30 cases (30 eyes), the total effective rate was 87%. CONCLUSION: Corneal ulcer debridement combined with conjunctiva flap covering surgery is a kind of effective and practical method in treatment of fungal corneal ulcer. It can be applied in primary hospital, and it is an effective method to control the fungus inflammation and save the eyeballs and remnant vision, which provide the further condition for corneal transplantation.