CAJ | 학술논문

目的探讨角膜清创联合羊膜移植羊膜覆盖治疗真菌性角膜炎的手术适应证的选择和临床效果.方法 2008年3月至2009年11月就诊的17例真菌性角膜炎患者,视力为FC/50cm～0.2,经角膜刮片法10%KOH溶液处理后查见菌丝,常规全身、局部抗真菌治疗3周至2个月后,患者病情迁延不愈,角膜涂片仍见菌丝.手术适应证为感染深度小于1/3角膜厚度,感染范围小于1/3角膜面积.手术方式:在局麻下行角膜清创,至角膜植床无明显感染迹象.溃疡面行羊膜小植片移植,角膜表面行羊膜大植片覆盖.术后结膜下注射0.2%氟康唑注射液0.5ml.结果 16例患者术后视力为0.5～1.0,感染得到控制.羊膜小植片与角膜融合,可见角膜组织内云翳形成.1例患者术后感染灶融解,改行板层角膜移植术后治愈.结论角膜清创联合羊膜移植羊膜覆盖可以有效治疗药物难以治愈的表浅真菌性角膜炎.良好的手术适应证的选择不仅可以治愈真菌性角膜炎,而且可以获得良好的术后视力.真菌复发和角膜融解是手术后的危险因素.
목적 탐토각막청창연합양막이식양막복개치료진균성각막염적수술괄응증적선택화림상효과.방법 2008년3월지2009년11월취진적17례진균성각막염환자,시력위FC/50cm～0.2,경각막괄편법10%KOH용액처리후사견균사,상규전신、국부항진균치료3주지2개월후,환자병정천연불유,각막도편잉견균사.수술괄응증위감염심도소우1/3각막후도,감염범위소우1/3각막면적.수술방식:재국마하행각막청창,지각막식상무명현감염적상.궤양면행양막소식편이식,각막표면행양막대식편복개.술후결막하주사0.2%불강서주사액0.5ml.결과 16례환자술후시력위0.5～1.0,감염득도공제.양막소식편여각막융합,가견각막조직내운예형성.1례환자술후감염조융해,개행판층각막이식술후치유.결론 각막청창연합양막이식양막복개가이유효치료약물난이치유적표천진균성각막염.량호적수술괄응증적선택불부가이치유진균성각막염,이차가이획득량호적술후시력.진균복발화각막융해시수술후적위험인소.
Objective To evaluate the efficiency ofamniotic membrane transplantation and amniotic membrane cover for fungal keratitis. Methods Amniotic membrane transplantation and amniotc membrane cover was done on 17 cases of fungal keratitis after infected tissue had been completely cleared in our hospital fiom March 2008 to November 2009. Results Amniotic membrane graft grown well. Sixteen cases of fungal keratitis were cured and visual acuity were 0.5-1.0, and one recurring case was performed lamellar keratoplasty and visual acuity was 0.2. Conclusions Amniotic membrane transplantation and amniotic membrane cover is an effective method for fungal keratitis.