We report the use of the femtosecond laser (IntraLase FS laser; Advanced Medical Optics, Inc, Santa Ana, Calif) to create a therapeutic lamellar keratectomy to facilitate the treatment of fungal keratitis. Lamellar keratectomy was used to remove infected tissue and more importantly to enhance penetration of topical antifungal medication in our patient with an aggressive Paecilomyces keratitis infection. The femtosecond laser (IntraLase) was used to create a 6-mm-diameter flap, which was converted to a cap with a thickness of 100 mum. The cap was then removed, exposing the infected stromal bed. Voriconazole, amphoter-icin, chlorhexidine, and polyhexamethylene biguanide, 1 drop each, were applied directly to the exposed stromal bed. Antifungal medication was continued while the patient's symptoms improved, visual acuity increased, and the corneal infiltrate became less prominent. After several months of steady improvement, antifungal medications were tapered. At that time, the patient displayed evidence of a flare-up of the infection. Penetrating keratoplasty was performed without complication, and the infection did not recur after the corneal transplant. Femtosecond laser may be useful in the treatment of advanced fungal keratitis.
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机译：我们报告使用飞秒激光（IntraLase FS激光; Advanced Medical Optics，Inc，圣安娜）来创建治疗性片状角膜切除术，以促进真菌性角膜炎的治疗。层状角膜切除术用于去除感染的组织，更重要的是，可以增强我们的侵袭性拟青霉菌性角膜炎患者的局部抗真菌药物的渗透性。飞秒激光（IntraLase）用于创建直径为6毫米的襟翼，将其转换为厚度为100微米的盖子。然后取下盖子，露出被感染的基质床。将伏立康唑，两性霉素，洗必太和聚六亚甲基双胍（每滴1滴）直接应用于裸露的基质床上。继续使用抗真菌药物，患者的症状得到改善，视力增加，角膜浸润不那么明显。经过几个月的稳定改善，抗真菌药物逐渐减少。当时，患者显示出感染爆发的迹象。穿透性角膜移植术无并发症，角膜移植术后感染未复发。飞秒激光可用于治疗晚期真菌性角膜炎。
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