The observation of clinical application of confocal microscopy in the diagnosis and treatment of fungal keratitis

Abstract

Objective To observe the effect of confocal microscopy in the diagnosis and treatments of fungal keratitis.Methods Fifty-four patients of fungal keratitis were selected from our hospital from 2011.9 to 2012.9,checked by confocal microscopy and cornea scraping.The changes of corneal lesion by confocal microscopy were examined,respectively in the lth,2th,3th,4th week.Results Fifty-two patients were diagnosed by confocal microscopy,diagnosis rate was 96.3％,49 patients were diagnosed by cornea scraping,diagnosis rate was 90.7％.The two diagnosis rate had no statistics difference (P ＞0.05).Among the patients,22 had hypopyum,49 had the history of trauma or foreign body,about 90.74％,the infection of 1 patient was not controlled and then cured by radical operation.By confocal microscopy,the anti-infective therapy effected at 2th week after anti-fungus therapy,pathogenetic condition improved at 2-3th week,and the infection was controlled at the 4th week,and then conjunctival flap covering or amniotic membrane grafting could be chosen to promote cornea recovery at this time.Conclusions Confocal microscopy examination is non-invasive and secure,with strong repeatability and short time,can be used to monitor the states and changes of comeal,can be used to conduct clinical therapy and improve the cure rate. Key words: Fungal keratitis; Confocal microscopy; Hypha; Diagnosis