[Treatment of fungal keratitis with partial lamellar keratoplasty].
OBJECTIVE
To study the indication and clinical effect of treatment of fungal keratitis with partial lamellar keratoplasty (LKP).


METHODS
Sixty-eight cases of fungal keratitis who could not be controlled by routine antifungal medicine were treated with partial LKP with the cornea donors cryopreserved in glycerin. All patients were followed up for 6 months to 3 years after surgery. The ratio of transparent grafts and surgical complications were recorded. The disease corneal sample was divided into 2 equal parts, one for fungal culture and the other for histopathologic examination.


RESULTS
Sixty-four cases (94%) resulted in successful resolution of fungal infection. The corrected visual acuities were 0.2 approximately 1.0; 4 cases (6%) recurred; positive fungal culture were found in 59 cases, and were identified as Fusarium in 41, Aspergillus in 8, Candida in 4, Penicillium in 2 and other Hyphomycetes in 4 cases. Hyphae in histologic sections of corneal buttons were detected in 61 cases. In most cases hyphae could not be found in the deeper layer of the sections except the 4 cases with recurrence.


CONCLUSIONS
Partial LKP is one of the effective operations that can succeed curing fungal infection which can not be controlled by antifungal medicines. It is effective for fungal keratitis whose infected lesion lies in the superficial or middle layer, especially when the corneal ulcer is widespread or not at the central area.
Shandong Eye Institute & Hospital, Qingdao 266071 China.
Weiyun
W
Shi
Shaowei
S
Li
Lixin
L
Xie
D000293:Adolescent; D000328:Adult; D003315:Cornea / Q000382:microbiology / Q000473:pathology / Q000601:surgery; D016039:Corneal Transplantation / Q000379:methods*; D005260:Female; D006801:Humans; D007634:Keratitis / Q000382:microbiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D003904:Mitosporic Fungi / Q000302:isolation & purification*; D009181:Mycoses / Q000601:surgery*; D016896:Treatment Outcome; D014792:Visual Acuity