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Wang JY, Wang DQ, Qi XL, et al. Modified ulcer debridement in the treatment of the superficial fungal infection of the cornea. Int J Ophthalmol. 2018;11(2):223-229doi: 10.18240/ijo.2018.02.07.
Wang, J. Y., Wang, D. Q., Qi, X. L., Cheng, J., & Xie, L. X. (2018). Modified ulcer debridement in the treatment of the superficial fungal infection of the cornea. International journal of ophthalmology, 11(2), 223-229. https://doi.org/10.18240/ijo.2018.02.07
Wang, Jun-Yi, et al. "Modified ulcer debridement in the treatment of the superficial fungal infection of the cornea." International journal of ophthalmology vol. 11,2 (2018): 223-229. doi: https://doi.org/10.18240/ijo.2018.02.07
Wang JY, Wang DQ, Qi XL, Cheng J, Xie LX. Modified ulcer debridement in the treatment of the superficial fungal infection of the cornea. Int J Ophthalmol. 2018 Feb 18;11(2):223-229. doi: 10.18240/ijo.2018.02.07. eCollection 2018. PMID: 29487810; PMCID: PMC5824075.
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Int J Ophthalmol. 2018 Feb 18;11(2):223-229. doi: 10.18240/ijo.2018.02.07. eCollection 2018.

Modified ulcer debridement in the treatment of the superficial fungal infection of the cornea.

International journal of ophthalmology

Jun-Yi Wang, Dian-Qiang Wang, Xiao-Lin Qi, Jun Cheng, Li-Xin Xie

Affiliations

  1. Department of Cornea, Qingdao Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao 266071, Shandong Province, China.

PMID: 29487810 PMCID: PMC5824075 DOI: 10.18240/ijo.2018.02.07

Abstract

AIM: To evaluate the efficacy of modified corneal ulcer debridement in superficial fungal keratitis unresponsive to medications.

METHODS: A total of 209 patients (209 eyes) with fungal keratitis, involving no more than 50% of the stromal depth and not responding to antifungal agents for 2wk, were recruited in this retrospective, noncomparative study. The patients were treated with modified corneal ulcer debridement. All visible corneal infiltrates were removed under an operating microscope to obtain a clean stromal bed and smooth incised edges. Antifungal drugs were used immediately after surgery. Healing time of the ulcers was recorded. Fungal recurrence, visual acuity, corneal thickness and risk factors for treatment failure were monitored.

RESULTS: The follow-up was 13.6±5.8mo. The corneal ulcers healed in 195 of 209 eyes (93.3%), with a mean healing time of 8.4±6.8d. The other 14 eyes were further treated by penetrating keratoplasty (PK) (1 eye), anterior lamellar keratoplasty (LK) (7 eyes), conjunctival flap covering (4 eyes) or amniotic membrane transplantation (2 eyes). The best corrected visual acuity (BCVA) was ≥20/70 in 80.3% of the eyes, ≥20/40 in 56.9% of the eyes, and ≥20/25 in 27.3% of the eyes. The corneas at the lesions became thinner, but all in the safe range. No fungal recurrence or corneal ectasis developed during the follow-up. The risk of treatment failure was higher in patients with preoperative hypopyon (

CONCLUSION: Modified surgical debridement is a simple and effective method for the treatment of superficial fungal infection of the cornea, with improved visual acuity and no recurrence. Such an intervention in time can rapidly control fungal infection and largely shorten corneal ulcer healing time.

Keywords: cornea ulcer; corneal scraping; debridement; fungal keratitis; superficial fungal infection

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