目的：：初步探讨全厚板层角膜移植术治疗铜绿假单胞菌感染性角膜溃疡的可行性、安全性和增视效果。方法：采用回顾性非对照研究,对临床确诊为铜绿假单胞菌感染的角膜溃疡且常规抗革兰氏阴性杆菌药物治疗、溃疡范围局限、濒临穿孔的患者25例25眼行全厚板层角膜移植术。术后第1 wk；第1,3,6,12,18 mo常规随访,观察角膜植片上皮愈合情况、有无感染复发、免疫排斥反应、植片透明度和最佳矫正视力等；术后第6 mo和第12 mo复查角膜内皮细胞密度。结果：术中无1例因后弹力层破裂而改行穿透性角膜移植术；仅1例在术后1 mo出现细菌感染,再次细菌培养未培养出铜绿假单胞菌,其余24例平均随访14±6mo,角膜植片均透明,治愈率为96%。术后第6mo,有16例术眼最佳矫正视力≥4.5,其中3例≥4.8。术后第6mo,平均角膜内皮细胞密度为2425±278个/mm2；术后第12mo为2257±326个/mm2。结论：全厚板层角膜移植术是一种治疗铜绿假单胞菌感染性角膜溃疡的有效手段,甘油保存的干燥角膜材料能够达到增视效果。%To explore the feasibility, safety and effect of the full-thickness lamellar keratoplasty for the treatment of pseudomonas aeruginosa corneal ulcer.METHODS: Based on a retrospective non-controlled study, 25 patients were given the full-thickness lamellar keratoplasty for clinical diagnosis of pseudomonas aeruginosa infection and corneal ulcer medication conventional anti-gram-negative bacteria. Routine follow-up were carried out at postoperative 1wk; 1, 3, 6, 12, 18mo to observe the situation of corneal epithelial healing, recurrent infection, immune rejection, graft transparency and best corrected visual acuity, etc. At the 6 and 12mo postoperative, corneal endothelial cell density was reexamined. RESULTS: No patients because of Descemet's membrane rupture underwent penetrating keratoplasty surgery: One only in cases of bacterial infection after 1mo, once again did not cultivate a culture of bacteria pseudomonas aeruginosa, and the remaining 24 cases average follow - up 14 ± 6mo, corneal graft were transparent, the cure rate was 96%. At the sixth month after surgery, there were 16 cases of eye surgery best corrected visual acuity ≥4. 5, of which 3 cases ≥4. 8. At the sixth month after surgery, the average corneal endothelial cell density 2 425 ± 278/mm2; At 12mo postoperatively, it was 2257± 326/mm2.CONCLUSlON: Full-thickness lamellar keratoplasty is an effective method of pseudomonas aeruginosa infection in the treatment of corneal ulcers, corneal drying material glycerol can be achieved by visual effects.
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