Preliminary application of low-temperature plasma ablation combined with drug therapy in the treatment of infectious corneal ulcer / 国际眼科杂志(Guoji Yanke Zazhi)

ABSTRACT

@#AIM: To observe the preliminary therapeutic effect of low-temperature plasma ablation combined with drugs in the treatment of infectious corneal ulcer. <p>METHODS: Retrospective case study. A total of 30 eyes were selected from 30 patients with infectious corneal ulcer who were admitted to the ophthalmology department of the First Affiliated Hospital of Chongqing Medical University from December 2018 to March 2020. All patients had positive etiological examination and ulcer or infiltration depth ≤1/2 of corneal thickness. Local low-temperature plasma ablation combined with eye drops was applied to the cases whose corneal ulcer did not improve significantly or corneal infiltration continued to worsen after 3-7d of conventional anti-infection treatment. Postoperative follow-up was 3-6mo to observe the clinical effect.<p>RESULTS: After low-temperature plasma ablation combined with eye drops treatment, the infection in 12 eyes of 12 patients with bacterial corneal ulcer was controlled in 11 eyes of 11 patients and ulcer healed gradually. Keratoplasty was performed in 1 eye due to aggravated infiltration. Among 18 eyes of 18 cases with fungal corneal ulcer receiving low-temperature plasma ablation and combined local antifungal treatment, 13 eyes of 13 cases gradually healed; 2 eyes of 2 patients showed lichen-like changes after the first ablation, but the lesion area was significantly smaller than before and gradually improved after re-ablation treatment; there was no effect in 3 eyes of 3 cases and keratoplasty was finally performed. All the patients were followed up for 3-6mo, 26 eyes of 26 patients were cured and the infection had no recurrence with remaining corneal pannus or leukoplakia. Confocal microscopy did not detect mycelium in cured patients with fungal infection.<p>CONCLUSION: In this preliminary observation, low-temperature plasma ablation combined with drug therapy can effectively control infection, promote healing and improve visual acuity for infective corneal ulcer with infiltration less than 1/2 corneal thickness, and no obvious complications were observed.