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应用部分穿透角膜移植治疗穿孔或即将穿孔的真菌性角膜溃疡,并将病变组织进行病理活检。结果19例(19只眼)中18例一次手术即有效控制角膜炎症,恢复有效视力。组织病理学显示,该病除有严重的炎症坏死性改变外,还呈增殖性改变。角膜溃疡周围及溃疡底部可见大量多形核白细胞、淋巴细胞和单核细胞,角膜胶原坏死断裂,玻璃体中可在菌丝及芽生孢子周围形成化脓病灶及肉芽肿。结论:真菌性角膜溃疡可能存在炎症反应和变态反应共同参与的病理机制,穿透角膜移植能成功的治疗真菌性角膜溃疡。
Part of the application of penetrating corneal transplantation for perforation or perforation of fungal corneal ulcer, and diseased tissue biopsy. Results Of the 19 cases (19 eyes), 18 cases of one operation were effective in controlling corneal inflammation and recovering effective visual acuity. Histopathology showed that in addition to severe inflammatory necrosis, the disease also showed a proliferative change. A large number of polymorphonuclear leucocytes, lymphocytes and monocytes were observed around corneal ulcer and at the bottom of ulcer. Corneal collagens were necrotic and necrotic, and suppurative lesions and granulomas were formed in the vitreous around hyphae and spores. CONCLUSION: Fungal corneal ulcer may have the pathological mechanism of inflammatory reaction and allergic reaction, and penetrating keratoplasty can successfully treat fungal corneal ulcer.