RESUMEN
AIM: To evaluate the efficacy and safety of corneoscleral separation in the treatment of persistent corneal ulcer.METHODS: Collected 22 cases (22 eyes) with deep corneal ulcer were treated with drugs.These patients underwent corneoscleral separation or corneal interstitial filling of sterile gelatin sponge,by retrospectively observing the cornea ulcer healing,anterior chamber reaction and separation of new blood vessels grow between the layers,and so on,the surgical indications,surgical techniques,postoperative complications and treatment were evaluated.RESULTS: Patients were followed up 3 to 6mo,of which 18 eyes cornea were seen a small amount of new blood vessels,anterior chamber empyema after 7-9d.Ulcers gradually narrowed,infection controlled,the surrounding edema relieved,visual acuity improved by varying degrees after 12-15d.Postoperative 4 eyes for the mixed infection,2 of the 4 eyes were of the rapid progress,neovascularization did not grow into the lesion,ulcers on the verge of perforation and then done penetrating keratoplasty.CONCLUSION: The aim of this study is to introduce deep limbal vessels into the surrounding of ulcer foci,which to combine with drug therapy is one of the effective methods to treat deep corneal infection.
RESUMEN
To explore the feasibility, safety and effect of the full-thickness lamellar keratoplasty for the treatment of pseudomonas aeruginosa corneal ulcer.METHODS: Based on a retrospective non-controlled study, 25 patients were given the full-thickness lamellar keratoplasty for clinical diagnosis of pseudomonas aeruginosa infection and corneal ulcer medication conventional anti-gram-negative bacteria. Routine follow-up were carried out at postoperative 1wk; 1, 3, 6, 12, 18mo to observe the situation of corneal epithelial healing, recurrent infection, immune rejection, graft transparency and best corrected visual acuity, etc. At the 6 and 12mo postoperative, corneal endothelial cell density was reexamined. RESULTS: No patients because of Descemet's membrane rupture underwent penetrating keratoplasty surgery: One only in cases of bacterial infection after 1mo, once again did not cultivate a culture of bacteria pseudomonas aeruginosa, and the remaining 24 cases average follow - up 14 ± 6mo, corneal graft were transparent, the cure rate was 96%. At the sixth month after surgery, there were 16 cases of eye surgery best corrected visual acuity ≥4. 5, of which 3 cases ≥4. 8. At the sixth month after surgery, the average corneal endothelial cell density 2 425 ± 278/mm2; At 12mo postoperatively, it was 2257± 326/mm2.CONCLUSlON: Full-thickness lamellar keratoplasty is an effective method of pseudomonas aeruginosa infection in the treatment of corneal ulcers, corneal drying material glycerol can be achieved by visual effects.