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首页> 外文期刊>British journal of ophthalmology >Therapeutic penetrating keratoplasty in severe fungal keratitis using cryopreserved donor corneas.
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Therapeutic penetrating keratoplasty in severe fungal keratitis using cryopreserved donor corneas.

机译：使用冷冻保存的供体角膜对严重的真菌性角膜炎进行治疗性穿透性角膜移植术。

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AIMS: To investigate whether cryopreserved donor cornea could be used for therapeutic penetrating keratoplasty (PKP) to eradicate the infection, obviate complications, and preserve anatomical integrity in severe fungal keratitis. METHODS: In this retrospective, consecutive case series, 45 eyes of 45 patients with severe fungal keratitis, which exhibited anterior chamber collapse, corneal perforation, and/or large suppurative corneal infiltrate, received therapeutic PKP after removal of the infected corneal tissue, irrigation of the anterior chamber by 0.2% fluconazole solution, iris dissection of fibrinoid membrane, and iridectomy and therapeutic PKP using corneas cryopreserved at -20 degrees C. RESULTS: Among 45 eyes, 39 eyes (86.7%) were successfully eradicated the fungal infection without recurrence and maintained their anatomical integrity without any complication. Four of 45 eyes (8.9%) showed postoperative rise of intraocular pressure, of which three were controlled with subsequent antiglaucoma surgeries, whereas one eye needed additional antiglaucoma medications. Two of 45 eyes (4.4%) were enucleated because of uncontrollable fungal infection and secondary retinal detachment, respectively. 23 eyes received subsequent optical PKP and, among them, 21 maintained clear corneal grafts and two suffered from graft failure due to allograft rejections. CONCLUSION: Cryopreserved donor corneas are effective substitutes in therapeutic PKP to control severe fungal corneal infection and preserve the global integrity, and may offer additional advantages over conventional PKP in reducing allograft rejection, eradicating fungal infection during the postoperative period, and improving the success of optical PKP for visual rehabilitation.
机译：目的：探讨冷冻保存的供体角膜是否可用于治疗性穿透性角膜移植术（PKP），以根除严重真菌性角膜炎的感染，避免并发症并保持解剖完整性。方法：在此回顾性连续病例系列中，对45例重度真菌性角膜炎患者的45只眼表现为前房塌陷，角膜穿孔和/或大量化脓性角膜浸润，在去除感染的角膜组织，冲洗灌洗液后接受了治疗性PKP结果：在45眼中，有39眼（86.7％）成功地根除了真菌感染，且未复发，并且使用0.2％氟康唑溶液前房，纤维蛋白膜虹膜剥离，虹膜切除术和使用-20°C冷冻的角膜的治疗性PKP。保持其解剖学完整性，无任何并发症。 45只眼中有4只（8.9％）显示术后眼内压升高，其中3只在随后的抗青光眼手术中得到控制，而另一只眼则需要额外的抗青光眼药物治疗。由于不可控制的真菌感染和继发性视网膜脱离，分别摘除了45只眼中的两只（4.4％）。 23眼接受了随后的光学PKP手术，其中21眼保持透明的角膜移植，其中2眼由于同种异体移植物排斥而遭受移植失败。结论：冷冻保存的供体角膜是治疗性PKP的有效替代品，可以控制严重的真菌性角膜感染并保持整体完整性，并且在减少同种异体移植排斥反应，消除术后的真菌感染以及提高光学手术的成功率方面，可能比常规PKP更具优势。 PKP用于视觉康复。

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