穿透性角膜移植治疗真菌性角膜溃疡的效果观察  

CLINICAL STUDY OF PENETRATING KERATOPLASTY FOR TREATMENT OF FUNGAL KERATITIS

作　　者：白海青[1] 金梅玲[1] 王传富[1] 孙为荣[1] 

机构地区：[1]青岛大学医学院附属医院眼科,青岛266003

出　　处：《青岛大学医学院学报》2000年第1期12-14,共3页Acta Academiae Medicinae Qingdao Universitatis

摘　　要：1目的　评价穿透性角膜移植 (PKP)对真菌性角膜溃疡的治疗效果。 2方法　对 15例 (15眼 )真菌性角膜溃疡行 PKP治疗 ,取下的病变角膜行细菌和真菌培养 ,光镜及电镜下行病理组织学检查 ,并随访。 3结果15例随访 90～ 180 d,12例植片透明 ,视力 0 .0 8者 1例 ,0 .1～ 0 .4者 11例 ;其余 3例因植片自溶、继发青光眼和眼内炎而失败。光镜检查表现为以真菌菌丝和分生孢子侵入及中性粒细胞浸润为主的广泛化脓性炎症。电镜提示 ,镰刀菌和曲霉菌均可致角膜基质细胞及胶原纤维变性、溶解 ,但角膜对两种真菌的免疫反应存在差异。 4结论　 PKP对真菌性角膜溃疡有挽救眼球和提高视力的双重作用。Objective To evaluate the effects of penetrating keratoplasty (PKP) in treatment of fungal keratitis. Methods 15 cases (15 eyes) with fungal keratitis were given PKP. The culture of bacteria and fungi and the examination of pathology and histology by light microscope and electron microscope in the cut off paracorneas were respectively conducted. The follow up survey of operation results in 15 cases was made for 90-180 days. Results 12 buttons were transparent. The visual acuity of 1 case was 0.08, 11 cases 0.1-0.4. The rest 3 cases failed because of immune rejection, secondary glaucoma and endophthalmitis. Light microscope study revealed that fungal keratitis was a kind of suppurative inflammation, including the invasion of fungal hyphae and conidia and the infusion of neutrocytes in large quantities. Electron microscope study showed that both Fusarium and aspergillus could result in lysis or degeneration of corneal cells and collagen. But the immune reactions of cornea to both kinds of fungi were different. Conclusion PKP is an effective measure for treatment of fungal keratitis. [

关 键 词：穿透性角膜移植 真菌性角膜 PKP 疗效 

分 类 号：R779.65[医药卫生—眼科]