Palliative surgery for refractory purulent corneal ulcer / 国际眼科杂志(Guoji Yanke Zazhi)

ABSTRACT

@#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.