Correlation Between Clinical Characteristics of Fungal Infection After Transplantation for Fungal Keratitis and Clinical Outcome
Objective To study the clinical characteristics of fungal infection after surgical treatment of fungal keratitis and analyze the relationship between the clinical characteristics and prognosis.Methods In this retrospective study,the clinical data and features of fungal infection patients after corneal surgery for fungal keratitis in Henan Eye Hospital from January 2009 to December 2019 were collected and analyzed.Results There were 12 cases(12 eyes),including 9 males and 3 females.Mean age was 54.83 years old(30 to 77 years old).Of the 12 patients,8 cases(66.7％)underwent evisceration of the eye,4 patients(33.3％)underwent penetrating corneal transplantation,3 cases had no recurrence and one case was lost in the follow-up of 12 to 75 months.All patients were moderate or serious conjunctival congestion,5 cases showed corneal graft edema and opacity,3 cases were corneal edema and opacity,2 cases were corneal bed opacity and 2 cases were abundant blood supply of conjunctiva flap without ulcer.In 3 cases,corneal neovascularization were found.Periodic acid-Schiff staining(PAS)and Gomori's methenamine silver staining(GMS)can find fungi in all patients,haematoxylin-eosin staining(HE)also find fungi in 4 patients.Eight patients who were failure after therapeutic keratoplasty showed corneal stroma purulent inflammation,whose corneal fibers were necrosis and were infiltrated by neutrophils.Fungal hyphae were found in corneal graft and bed in three cases.In one case,fungus was located in the deep layer of corneal bed.The graft and bed structure were not identified in 4 cases,and fungus was found in the cornea.Conclusion Though corneal surgery could give a broadened therapeutic window for fungal keratitis patients,the important factors of prognosis of the treatment are the presence of fungal hyphae and the amount of the hyphae in the graft.It should be paid more attention to improve the prognosis of the disease.
万方数据
维普
