Two-step strategy—conjunctival flap covering surgery combined with secondary deep anterior lamellar keratoplasty for the treatment of high-risk fungal keratitis
作者机构：Department of OphthalmologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430022Hubei ProvinceChina
出 版 物：《International Journal of Ophthalmology(English edition)》 (国际眼科杂志（英文版）)
年 卷 期：2023年第16卷第7期
页 面：1065-1070页
核心收录：
学科分类：1002[医学-临床医学] 100212[医学-眼科学] 10[医学]
基 金：Supported by the National Natural Science Foundation of China(No.82171025 No.82070934) the Fundamental Research Funds for the Central Universities(No.HUST:2019kfy XMBZ065) the Key Research and Development Program of Hubei Province(No.2021BCA146) the Clinical Research Foundation of Wuhan Union Hospital(No.2021xhlcyj03)
主 题：high-risk fungal keratitis conjunctival flap deep anterior lamellar keratoplasty two-step strategy
摘 要：AIM:To investigate whether the two-step strategy[conjunctival flap covering surgery(CFCS)combined with secondary deep anterior lamellar keratoplasty(DALK)]is effective for patients with high-risk fungal keratitis(FK).METHODS:In this noncomparative,retrospective case series,10 subjects(6 males,4 females)with a mean age of 56.5±7.1(range 47-72)y with high-risk FK undergone the two-step strategy were *** outcome measures were healing of the corneal ulcer,recurrence of FK,reject reaction,improvement in best corrected visual acuity(BCVA)and relevant ***:The average diameter of corneal infiltrates was 7.50±0.39 mm,ranging from 6.94 to 8.13 *** mean depth of corneal infiltrates was 422.4±77.1μm,ranging from 350 to 535μ*** mean corneal thickness was 597.4±117.3μm,ranging from 458 to 851μ*** and endothelial plaques were presented in all *** period between the two steps was 3.65±0.9(ranging from 3 to 5)*** graft diameter was 7.75±0.39 *** the last follow-up(average 9.25±3.39,ranging from 5.5 to 17mo),no fungal recurrence or graft rejection appeared,and all patients showed improvement of *** patient suffered from liver function impairment due to oral voriconazole for 4wk and recovered spontaneously after 1wk of drug ***:The two-step strategy is safe and effective in the treatment of high-risk FK by transforming intentional therapeutic penetrating keratoplasty during acute infection to later optical *** is a practical strategy,especially in areas lacking fresh donor corneas and eye bank services.
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