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@#AIM: To investigate the clinical effect of autologous penetrating keratoplasty in the treatment of corneal blindness. <p>METHODS: Totally 8 patients with corneal blindness were treated by autologous penetrating keratoplasty in our hospital from 2014-01 to 2018-03. Using retrospective analysis, the patients were followed up for one year. To observe the intraoperative complications and postoperative conditions such as visual acuity, corneal transparency, and other were observed.<p>RESULTS: The uncorrected visual acuity of all the 8 patients was greater than 0.02 1wk after operation, and the rate of restoration of visual acuity was 100%(8/8). The corrected visual acuity of 5 patients(5-8)was more than 0.3 1mo after operation. The corrected visual acuity of 3 patients(3-8)with severe cataract before operation was improved to 0.08-0.2. One year later, all the corneal grafts in the recipient eyes were transparency and no recurrence of infection or secondary infection occurred in all 8 patients. <p>CONCLUSION: Corneal graft is easy to grow and there are no exclusion reactions, fewer postoperative complications after autologous corneal transplantation. So, corneal implants can remain transparent for a long time, and the surgery cost is lower. Autologous corneal transplantation can not only provide long-term useful vision for patients with monocular blindness combined with corneal blindness, but also reduce their financial burden and bring great benefits to patients.
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@#AIM:To investigate the clinical effect of scleral allograft combined with conjunctival flap autograft for refractory purulent corneal ulcer. <p>METHODS: Twenty patients(20 eyes)with purulent corneal ulcer admitted to our hospital during June 2015 to June 2017 were selected. The results showed that the drug treatment was not effective and could not be performed by penetrating keratoplasty, and then allogeneic scleral transplantation combined with conjunctival flap autograft covering was performed. A retrospective analysis was carried out. The intraoperative complications, postoperative scleral and conjunctival flap growth and postoperative complications of this palliative operation were observed. <p>RESULTS: Of the 20 patients, 18 had good growth of sclera and conjunctival flap, the cure rate was 90%. One case had bad healing of conjunctival flap and was cured by amniotic membrane transplantation; 1 case had enucleation because of severe vitreous cavity infection; 2 cases had lens prolapse, the incidence rate was 10%. Secondary glaucoma occurred in 3 cases with an incidence of 15%, which was cured by cryociliary surgery.<p>CONCLUSION:Scleral allograft combined with conjunctival flap autograft is a palliative operation. It is an effective way to control the corneal infection and maintain the appearance of the eyeball in the patients with severe purulent corneal ulcer, which is ineffective in drug treatment and unable to perform penetrating keratoplasty. It can replace the previous enucleation of the eye contents to control the infection. It can not only avoid the eye pain and psychological trauma caused by the loss of eyeball, but also save money for improving the appearance in the later stage.
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AIM:To analyze the clinical efficacy of conjunctival flap covering combined with subconjunctival injection of fluconazole on patients with severe fungal corneal ulcer.METHODS:Totally 50 cases with severe fungal corneal ulcer were collected in our hospital from January 2012 to December 2015.The cases were randomly divided into observation group and control group,25 cases in each group.All the cases were monocular sick.The control group took single drug treatment,but the observation group were given with conjunctival flap as an extra.The clinical efficacy,best corrected visual acuity and adverse effects rate were observed.And,the relapse of the two groups was followed for 1a.RESULTS:After 1 mo of treatment,the clinical curative effect of the observation group was significantly higher than the control group (P＜ 0.05),and corrected visual acuity of the observation group was higher than the control group (P＜0.05);the adverse reaction rate of the observation group was lower than the control group (P＜0.05).After 1a follow-up,the observation group only had 1 case of recurrence,control group had 8 cases with recurrence,the recurrence rate of the observation group was significantly lower than the control group (P＜0.05).CONCLUSION:The conjunctival flap combined with subconjunctival injection of fluconazole has good application value in severe fungal corneal ulcer patients,can effectively improve the clinical curative effect and the visual acuity,and can effectively reduce the incidence of adverse reactions and recurrence rate.