论文部分内容阅读
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。
1 Objective To evaluate the therapeutic effect of penetrating keratoplasty (PKP) on fungal corneal ulcer. 2 Methods Fifteen patients (15 eyes) with fungal keratitis were treated with PKP. The cornea removed from the diseased cornea was cultured with bacteria and fungi. Pathological examination was performed by light and electron microscopy and followed up. 3 Results 15 cases were followed up 90 ~ 180 d, 12 cases of transparent, visual acuity 0.08 in 1 case, 0.1 to 0.4 in 11 cases; the other 3 cases of autopsy due to autograft, secondary glaucoma and eye Internal inflammation and failure. Light microscopy showed fungal hyphae and conidia and neutrophil infiltration of the main purulent inflammation. Electron microscopy suggested that both Fusarium and Aspergillus could degenerate and dissolve corneal stromal cells and collagen fibers, but there were differences in the immune response between the two fungi. 4 Conclusion PKP fungal corneal ulcer have the dual role of saving the eye and improve vision.