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目的 :观察真菌性角膜溃疡角膜移植术后应用免疫抑制剂和皮质类固醇激素的疗效和最佳应用时间。方法 :5 4例真菌性角膜溃疡患者行穿透性角膜移植后随机分为两组 ,1组术后用大扶康眼液滴眼 ,2周后加用环胞霉素 A眼液滴眼和常规全身使用皮质类固醇激素 ,另 1组术后只用大扶康眼液滴眼 ,出现排斥反应后才加用免疫抑制剂和皮质类固醇激素。裂隙灯观察并记录前房反应和角膜植片情况。结果 :常规使用免疫抑制剂和皮质类固醇组与对照组比较 :前组前房反应轻、角膜植片排斥反应发生率低且症状轻 ,亦未见真菌复发率增高。结论 :真菌性角膜溃疡行角膜移植术后 ,只要掌握好使用免疫抑制剂和皮质类固醇激素的时间和剂量 ,既安全 ,又可减轻术眼炎症反应 ,减少术后排斥反应的发生
Objective: To observe the efficacy and best time of application of immunosuppressive agents and corticosteroids after corneal ulcer fungal corneal transplantation. Methods: Fifty-four patients with fungal corneal ulcer were divided into two groups randomly after penetrating keratoplasty. One group was treated with Da Fu Kang eye drops after operation and two weeks later with cyclosporine A eye drops And conventional systemic corticosteroid use, the other group only after Daofukang eye drops, rejection after the addition of immunosuppressive agents and corticosteroids. Slit lamp observation and record of anterior chamber reaction and corneal graft situation. Results: Compared with the control group, the conventional immunosuppressive agents and corticosteroids group showed less reaction in the anterior chamber, less incidence of rejection and fewer symptoms of corneal graft rejection, and no increase in the recurrence rate of the fungus. Conclusions: After corneal transplantation of fungal corneal ulcer, as long as the time and dosage of immunosuppressive agents and corticosteroids are mastered, it is safe and can reduce the inflammatory reaction and reduce the occurrence of postoperative rejection