【摘要】 目的探讨穿透性角膜移植术(PKP)治疗真菌性角膜溃疡的手术适应证选择的安全性和可行性。方法2000年1月至2005年12月在我院因真菌性角膜溃疡行PKP并具有完整病例资料的147例(147只眼)患者进行长期随访,并为3种手术适应证的选择提供客观的依据。结果随访10～70个月,平均为(25.4±13.9)个月。眼球保存率87.8%(129/147),真菌复发率为6.1%(9/147)。73.6%(95/129)患者角膜植片透明,最佳矫正视力44只眼介于0.1～0.3,51只眼介于0.4～0.8,较术前明显提高。结论药物治疗无效且感染已累及角膜全层、角膜穿孔的真菌性角膜溃疡行板层角膜移植(LKP)术后复发均是PKP治疗真菌性角膜溃疡的适应证选择范围。病理组织学可以为PKP手术适应证选择的可行性提供可靠的理论依据;而术后疗效的长期随访则进一步证实了其安全性。更多还原

【Abstract】 Ojbective To evaluate the safety and efficiency of penetrating keratoplasty (PKP) to treat the fungal keratitis in surgical indication selection. Methods We have reviewed 147 patients (147 eyes) of fungal keratitis (FK) and summarized the criteria for surgical indication selection from the January 2000 to December 2005. Results The follow-up period was 10 to 70 months, mean 25.4±13.9months. There was 87.8% of eye integrity and 6.1% of fungal recurrence. At the end, 73.6%(95/129) patients remained clear corneal graft. The postoperative best-corrected vision acuity obviously improved compared with the preoperative acuity, including 44 patients ranged from 0.1 to 0.3, 51 patients from 0.4 to 0.8. Conclusions The appropriate surgical indication of PKP for FK involves severe infection of complete cornea unresponsive to the conventional anti-fungi medication, corneal perforation, FK recurrence after lamella keratoplasty for FK. The feasibility of PKP for FK relies on the postoperative histopathological examination, while the surgery safety is confirmed by long-term follow-up observation.更多还原