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张凌,瞿玲辉,杨于力,曾圆圆,谢汉平.角膜基质层间注射两性霉素B治疗难治性真菌性角膜溃疡的临床观察[J].陆军军医大学学报(原第三军医大学学报),2012,34(24):2507-2510.
Zhang Ling,Qu Linghui,Yang Yuli,Zeng Yuanyuan,Xie Hanping.Clinical effectiveness of intrastromal amphotericin B injection for refractory fungal keratohelcosis[J].J Amry Med Univ (J Third Mil Med Univ),2012,34(24):2507-2510.
张凌,瞿玲辉,杨于力,曾圆圆,谢汉平.角膜基质层间注射两性霉素B治疗难治性真菌性角膜溃疡的临床观察[J].陆军军医大学学报(原第三军医大学学报),2012,34(24):2507-2510. DOI:
Zhang Ling,Qu Linghui,Yang Yuli,Zeng Yuanyuan,Xie Hanping.Clinical effectiveness of intrastromal amphotericin B injection for refractory fungal keratohelcosis[J].J Amry Med Univ (J Third Mil Med Univ),2012,34(24):2507-2510. DOI:
目的 初步评价角膜基质层间注射两性霉素B治疗难治性真菌性角膜溃疡的效果,探索真菌性角膜溃疡局部治疗的新方法。 方法 诊断为真菌性角膜溃疡的6例患者(6只眼),男性3例,女性3例,年龄32~68(46.0±13.6)岁,在抗真菌滴眼液治疗2周或以上效果不明显者,采用30 G针头予以7.5 μg/0.1 ml两性霉素B 0.1 ml围绕角膜溃疡周围透明角膜的基质层内注射,每隔3天1次,继续辅以那他霉素滴眼液等抗真菌治疗,随访观察患者术后病情变化。 结果 6例患者接受角膜基质层间注射两性霉素B治疗的病程平均为9.8周,手术前视力从手动/眼前至0.1,每例患者经3~5次角膜基质层间注射两性霉素B治疗后,4例患者的视力明显提高,另2例患者视力稳定,随访时最佳视力从CF/10 cm~0.4,患者的角膜溃疡均愈合,遗留部分角膜白斑或云翳,平均随访半年无严重手术并发症发生。 结论 角膜基质层间注射两性霉素B是一种有效、安全的治疗真菌性角膜溃疡的方法。
Objective To evaluate the therapeutic effectiveness of intrastromal amphotericin B (AmB) injection in the treatment of refractory fungal keratohelcosis in order to explore a new way for topical treatment. Methods A total of 6 eyes from 6 patients who were diagnosed as fungal keratohelcosis and had no obvious response to a over-2-week treatment of topical antifungal eye-drops were enrolled in the study. They were given intrastromal injection of AmB (7.5 μg in 0.1 ml) at the periphery clear cornea with a 30-gauge patented corneal stroma injection needle
once every 3 d
and were also treated with topical antifungal eye-drops. The clinical efficacy and outcomes were assessed after the treatment and during follow-up. Results Six patients included 3 males and 3 females
with a mean age of 46.0±13.6
and their mean course of disease was 9.8 weeks. Before the intrastromal injection
their best-corrected visual acuity (BCVA) ranged from hand movement (HM) to 0.1. After giving 3 to 5 times of intrastromal injections for each patient
VA of 4 patients was increased greatly
and that of the other 2 maintained the same. The BCVA reached from CF/10cm to 0.4. All eyes healed with corneal scar formation
and no serious complication occurred during the 6 months’ follow-ups. Conclusion Intrastromal injection of AmB is an effective and safe way for refractory fungal keratohelcosis.
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