Full-thickness conjunctival flap covering surgery combined with amniotic membrane transplantation for severe fungal keratitis.
Full-thickness conjunctival flap covering surgery combined with amniotic membrane transplantation for severe fungal keratitis.
复制标题
DOI：
10.3892/etm.2018.5765
复制
发表时间：
2018-03
影响因子：
2.7
通讯作者：
Yuan J
中科院分区：
文献类型：
--
作者：
Zhong J;Wang B;Li S;Deng Y;Huang H;Chen L;Yuan J
真菌性角膜炎是一种严重而常见的眼部感染性疾病。本研究评价了全层结膜瓣覆盖联合羊膜移植（FCCS + AMT）作为重症真菌性角膜炎过渡性手术的疗效。2010年1月至2015年12月期间，共有17例重度真菌性角膜炎患者（无角膜穿孔）接受了FCCS + AMT。评价FCCS + AMT的发病因素、术前诊断及术后3个月的预后。随后，7例患者接受了巩膜角膜移植术，并在术后1个月分析了最佳矫正视力（BCVA）和复发率。主要危险因素是农业创伤（7例），其次是非农业物体进入眼睛（3例）。术前共焦显微镜检查阳性真菌性角膜炎10例，角膜刮片检查阳性真菌性角膜炎9例。FCCS + AMT术后3个月，眼球保存率为88.24%，15/17例患者显示结膜上皮完全再生，结膜表面光滑，无任何并发症。共有2例（11.76%）患者发生结膜瓣融化和眼内炎，随后接受了眼内容摘除术。共7例患者接受了巩膜角膜移植术，1个月时最小分辨率角的平均对数（0.689±0.121; P<0.001）与术前（2.459±0.037）和FCCS + AMT后的BCVA值（2.529±0.066）相比有显著改善。在随访期间没有观察到任何病例复发。结论：FCCS + AMT是治疗全角膜溃疡无穿孔的严重真菌性角膜炎的较好方法，可挽救眼球，为角膜移植提供更大的机会。
Fungal keratitis is a severe and common ocular infectious disease. The present study evaluated the efficiency of full-thickness conjunctival flap covering surgery with amniotic membrane transplantation (FCCS + AMT) as a transitional surgery for severe fungal keratitis. A total of 17 patients with severe fungal keratitis without corneal perforation underwent FCCS + AMT between January 2010 and December 2015. The pathogenic factors, preoperative diagnosis and postoperative prognosis of FCCS + AMT at 3 months were evaluated. Subsequently, 7 patients received sclerokeratoplasty, and the best-corrected visual acuity (BCVA) and recurrence ratio were analyzed at 1 month postoperatively. The primary risk factor was agricultural trauma (7 cases), followed by a non-agricultural object entering the eye (3 cases). Preoperatively, there were 10 cases of fungal keratitis positively identified using confocal microscopy and 9 cases positively identified by corneal scrapings. A total of 3 months following FCCS + AMT, the percentage of cases resulting in preservation of the eyeball was 88.24%, with 15/17 patients demonstrating complete conjunctival re-epithelization and a smooth conjunctival surface without any complications. A total of 2 (11.76%) patients experienced melting of the conjunctival flap and development of endophthalmitis, and subsequently underwent ocular evisceration surgery. A total of 7 patients underwent sclerokeratoplasty and the mean logarithm of the minimum angle of resolution BCVA at 1 month was significantly improved (0.689±0.121; P<0.001) compared with preoperative values (2.459±0.037) and BCVA values following FCCS + AMT (2.529±0.066). No recurrence was observed in any of the cases during the follow-up period. Conclusively, FCCS + AMT may be a preferable treatment for severe fungal keratitis of the entire corneal ulcer without perforation, and may save the eyeball and provide a greater opportunity for corneal transplantation.
登录
查看更多内容
影响因子：
2
作者：
Cao J;Yang Y;Yang W;Wu R;Xiao X;Yuan J;Xing Y;Tan X
通讯作者：
Tan X
影响因子：
--
作者：
Khodadoust, A;Quinter, AP
通讯作者：
Quinter, AP
中国角膜移植术的局限性：调查分析
影响因子：
3.7
作者：
Hong J;Shi W;Liu Z;Pineda R;Cui X;Sun X;Xu J
通讯作者：
Xu J
影响因子：
0.7
作者：
Liu J;Sheha H;Fu Y;Liang L;Tseng SC
通讯作者：
Tseng SC
影响因子：
4.1
作者：
Abdulhalim, Bahaa-Eldin Hasan;Wagih, Mostafa Mohamed;Nagy, Ragy R. S.
通讯作者：
Nagy, Ragy R. S.