[Evaluation of the results of therapeutic lamellar keratoplasty and penetrating keratoplasty for fungal corneal ulcer].
OBJECTIVE
To evaluate the effects of therapeutic lamellar and penetrating keratoplasty for fungal corneal ulcer.


METHODS
Donor corneas preserved in pure glycerine or water-free calcium chloride were used in corneal transplantation for fungal corneal ulcers that were poorly responsive to the anti-fungal medical treatment, 5% iodine was used in lamellar keratoplasty to kill the fungi in the recipient bed, and diluted or original solution of fluconazole was used in penetrating keratoplasty to wash the anterior chamber.


RESULTS
In the lamellar keratoplasty group, there were 23 cases; 18 cases were cured with one surgery and 3 cases were cured after second surgery, the success rate being 91.3%. There were 2 cases with recurrence of corneal inflammation, and the lesion was controlled by penetrating keratoplasty. The penetrating keratoplasty group included 31 cases, of them, 27 cases were cured with one surgery and 4 eyes were enucleated due to recurrent corneal inflammation or refractive glaucoma. In the total 54 cases, the inflammation was controlled in 50 cases after therapeutic corneal transplantation, success rate being 92.6%.


CONCLUSIONS
For those fungal corneal ulcers that are poorly responsive to anti-fungus eye drops, it is recommended to perform lamellar keratoplasty if the ulcer is located in the anterior 1/2 stroma, the key points of surgery are to remove the affected tissue completely and cauterize the recipient bed with 5% iodine. For deep ulcers or nearly perforative or perforated ulcers, diluted or original solution of diflucan is used to wash the anterior chamber during penetrating keratoplasty, that can help to improve the success rate.
Wang
R
R
Department of Ophthalmology, Affiliated Tong Ren Hospital, Capital Medical University, Beijing 100730, China.
Zou
L
L
Dong
D
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D003320:Corneal Ulcer / Q000601:surgery*; D015821:Eye Infections, Fungal / Q000601:surgery*; D005260:Female; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology