Observation of the effects that fungal keratitis treated by corneal lamellar resection combined with amniotic membrane (AM) transplantation using confocal microscopy

Abstract

Objective To observe the effects that fungal keratitis treated by corneal lamellar resection combined with amniotic membrane transplantation using confocal microscopy.Methods Thirty patients (30 eyes),treated from January 2010 to June 2011,whose cornea lesion didn't involve the endothelial layer of cornea and diagnosed as fungal keratitis by confocal microscopy,were admitted into our study.All the patients received corneal lamellar resection combined with amniotic membrane transplantation after using antifungal medicine for one week.Confocal microscopy was used to observe the particular lesion of each eye,respectively,before and 7,14,21,and 28 days,3 and 6 month after the treatment.The changes of visual acuity were observed.Results Before treatment,visual acuity of 21 eyes was ≤0.05,9 in 0.05-0.2.The final visual acuity was that 3 eyes were ≤ 0.05,24 in 0.05 to 0.2,and 3 ≥ 0.2.The difference of decreasing visual acuity was statistically significant (Zc=4.2007,P ≤0.001).Conclusions Confocal microscopy is a fine choice to assess the effect of medicine treatment for fungal keratitis,and can provide an objective evidence for choosing medication in clinic. Key words: Keratitis; Confocal laser microscope; Corneal lamellar resection; Amniotic membrane transplantation