Treatment of fungal keratitis by corneal iameilar resection combined with amniotic membrane tranplantion and conjunctival flap covering

Abstract

Objective To evaluate the effect of corneal lamellar resection plus amiotic membrane (AM) transplantation combind with conjunctival flap covering for fungal keratitis. Methods The corneal lamella of focus was resected and covered with preserved or fresh amniotic membrane which was immersed in Fluconazole injection solution for half an hour and conjunctival flap. The AM and conjunctival flap were fixed up by suture. The conjunctival pedicle was snipped under surface anaesthesia and removed the suture after one motth. Results Keratitis of 19 eyes was controled, AM was totally or partly absorbed. Conjunctiva and cornea healed up when suture was removed. Following-up 6 months to 3 years, visual acuities of 8 eyes were CF ～ 0.1,11 eyes were 0.2 ～ 0.5. All of conjunctival flaps were translucent in healing up. Blood vessels were atrophic, and most hollows of corneal surface became shallow. Conclusions This measure is one of efficient ways for treatment of fungal keratitis. Key words: fungal keratitis; corneal lamellar resection; counjunctiva; anmiotic membrane; surgery