Department of Ophthalmology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Hirokoji-agaru, Kawaramachi-dori, Kamigyo-ku, Kyoto, 602-0841, Japan.
Department of Ophthalmology, North Medical Center Kyoto Prefectural University of Medicine, Kyoto, Japan.
Jpn J Ophthalmol. 2020 Mar;64(2):228-233. doi: 10.1007/s10384-020-00718-3. Epub 2020 Jan 28.
To evaluate the safety of retrocorneal plaque aspiration in patients with fungal keratitis.
Retrospective study.
A retrospective case series of fungal keratitis seen at Kyoto Prefectural University of Medicine between November 2013 and September 2018. Patients with retrocorneal plaque who underwent retrocorneal plaque aspiration for the diagnosis and treatment of fungal keratitis were included. The retrocorneal plaques were either aspirated using a tuberculin syringe with a 27-gauge blunt needle or were directly pulled out using a forceps. The anterior chamber was carefully washed out using bimanual irrigation and aspiration (I/A). Diagnosis accuracy and treatment safety were evaluated.
Five eyes of five patients aged 68.4 ± 13.0 years old (range: 45-81 years) were included. Three of the five patients (60%) were positive for fungus obtained from corneal scrapings. Retrocorneal plaque aspiration improved the diagnosis accuracy to five out of five patients (100%), including two cases positive to Fungiflora Y staining. Three of the five patients (60%) had good response rapidly after retrocorneal plaque aspiration, and two patients received therapeutic keratoplasty. All cases were finally stabilized without severe complications.
Retrocorneal plaque aspiration may be useful for the precise diagnosis of fungal keratitis.
评估真菌性角膜炎患者后弹力层角膜下刮吸术（retrocorneal plaque aspiration）的安全性。
回顾性研究。
回顾性病例系列研究，纳入 2013 年 11 月至 2018 年 9 月在京都府立医科大学就诊的真菌性角膜炎患者。纳入接受后弹力层角膜下刮吸术以诊断和治疗真菌性角膜炎的患者。后弹力层角膜下刮吸术采用 27 号钝针头的结核菌素注射器抽吸，或直接用镊子拔出。采用双手冲洗和抽吸（I/A）仔细冲洗前房。评估诊断准确性和治疗安全性。
纳入 5 例 5 眼（5 例患者年龄 68.4 ± 13.0 岁，范围：45-81 岁）。5 例患者中有 3 例（60%）角膜刮片真菌阳性。后弹力层角膜下刮吸术将诊断准确性提高至 5 例（100%），包括 2 例 Fungiflora Y 染色阳性。后弹力层角膜下刮吸术后，5 例患者中有 3 例（60%）迅速出现良好反应，其中 2 例患者接受了治疗性角膜移植术。所有病例最终均稳定，无严重并发症。
后弹力层角膜下刮吸术可能有助于真菌性角膜炎的精确诊断。
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