Xie Li-xin, Zhai Hua-lei
Qingdao Eye Hospital, Shandong Eye Institute, Qingdao 266071, China.
Zhonghua Yan Ke Za Zhi. 2005 Nov;41(11):1009-13.
To evaluate the outcome of penetrating keratoplasty (PKP) for the treatment of fungal keratitis with corneal perforation.
40 patients (40 eyes) with corneal perforation secondary to fungal keratitis underwent PKP at Qingdao Eye Hospital from 1994 to 2003. The follow-up ranged from 6-24 months. The postoperative visual acuity and complications were documented.
39 (97.5%) patients preserved the eyeballs. The visual acuity improved in 38 (95.0%) eyes. Fungal infection recurred in 4 eyes, 3 of which were controlled with antifungal medication and 1 was enucleated because of the uncontrolled endophthalmitis. Graft rejection was observed in 15 (37.5%) eyes, 12 of which were cured with medication and 3 received secondary PKP. 3 (7.5%) eyes had graft ulceration, 2 of which were cured and the other one was regrafted because of severe endothelial cell loss. 5 (12.5%) eyes had secondary glaucoma, and the intraocular pressure was controlled medically and surgically. Complicated cataract occurred in 5 (12.5%) eyes, 3 of which underwent cataract extraction. Most complications were controlled successfully. At last follow-up, 36 (90.0%) grafts were clear.
PKP is an effective approach for preservation of eyeballs and restoration of visual function in patients eyes with fungal keratitis and corneal perforation.
评估穿透性角膜移植术（PKP）治疗真菌性角膜炎伴角膜穿孔的疗效。
1994年至2003年，40例（40眼）真菌性角膜炎继发角膜穿孔患者在青岛眼科医院接受了PKP治疗。随访时间为6至24个月。记录术后视力及并发症情况。
39例（97.5%）患者保住了眼球。38眼（95.0%）视力得到改善。4眼真菌感染复发，其中3眼经抗真菌药物治疗得到控制，1眼因眼内炎无法控制而被摘除眼球。15眼（37.5%）发生植片排斥反应，其中12眼经药物治疗痊愈，3眼接受了二次PKP。3眼（7.5%）发生植片溃疡，2眼治愈，另1眼因严重内皮细胞丢失而再次移植。5眼（12.5%）发生继发性青光眼，眼压经药物和手术治疗得到控制。5眼（12.5%）发生并发性白内障，其中3眼接受了白内障摘除术。多数并发症得到成功控制。末次随访时，36片（90.0%）植片透明。
PKP是保存真菌性角膜炎伴角膜穿孔患者眼球及恢复视功能的有效方法。
