Clinical Analysis Of Drug Combined With Surgery In The Treatment Of Refractory Corneal Ulcer In Cats

Corneal ulcer is a broad concept.Any loss of corneal epithelium can be called corneal ulcer.It is one of the common ophthalmic diseases in clinic.Most of them are secondary infections due to corneal injury.Clinical symptoms include tears,conjunctival congestion,blepharospasm and purulent secretion.Simple corneal ulcer is usually cured by local medicine,but when the ulcer does not heal for a long time,it is easy to turn into refractory corneal ulcer.When developing into deep corneal ulcer,it is easy to cause corneal perforation.When the cornea is perforated or near perforation,the vision is seriously damaged and the drug treatment can not control the development of the disease,it will become refractory corneal ulcer,and surgical treatment is needed at this time.With the improvement of living standards and the increasing number of pet owners,in order to effectively diagnose and treat corneal ulcers,this paper selects the period from June 1,2020 to March 1,2021.There were 120 cases of corneal ulcer and 139 cases of eye.To provide theoretical basis for the diagnosis of corneal ulcer in cats by drug therapy and combined operation after ineffective drug therapy.(1)The grade of corneal ulcer is evaluated by clinical diagnosis combined with ophthalmic examination and laboratory examination,which is divided into mild,moderate and severe,and the etiology is diagnosed.Fungal corneal ulcers are generally treated with antifungal drugs,such as amphotericin B、 natamycin,fluconazole,itraconazole capsules,and cyclosporine eye drops,such as immunosuppressants;when viral corneal ulcers occur,pathogen-sensitive antiviral drugs are selected to treat inflammation,such as acyclovir eye drops,ganciclovir eye gels,when symptoms are severe,or when viruses are accompanied by systemic reactions,systemic antiviral therapy can be used to prevent exacerbation of infection;Tobramycin combined with cephalosporins or fluoroquinolones combined with cephalosporins were the first choice for bacterial corneal ulcers.The treatment of doxycycline hydrochloride,ciprofloxacin and aminoglycoside(gentamicin)or levofloxacin eye drops(colapital),tobramycin eye drops(tobents),ofloxacin(talibitto)local spot eyes combined with neomycin sulfate anti-inflammatory eye ointment was better.(2)Drug treatment,If the drug is ineffective,it is refractory corneal ulcer and combined with surgery,The operation methods are as follows: corneal ulcer debridement,lamellar keratectomy,conjunctival flap covering,conjunctival flap covering,eyelid varus correction and keratoplasty,Treatment of different degrees of corneal ulcer with drugs combined with surgery :5 cases of mild corneal ulcer,The effective number is 5,The effective rate was 100.00%;Treatment of 9 cases with moderate corneal ulcer,The effective number is 8,The effective rate was 88.89 per cent;Treatment of 32 patients with severe corneal ulcer,The effective number is 29,The effective rate was 90.63.Drugs combined with surgery for refractory corneal ulcers,Very efficient.Drug combined surgery for different types of corneal ulcers: treatment of superficial corneal ulcers in 4cases,The effective number is 4,The effective rate was 100.00%;Treatment of 24 patients with complicated corneal ulcer,The effective number was 23,The effective rate was 95.83 per cent;Treatment of 14 patients with deep corneal ulcer,The effective number was 12,The effective rate was 85.71 per cent;Treatment of marginal corneal ulcer in 4 cases,The effective number is 3cases,The effective rate was 75.00.The total effective rate of drug therapy was 66.91%,The effective rate of combined surgical treatment after ineffective drug treatment was 91.30.Results and analysis of the causes of different corneal ulcer infection by drug combined operation :11cases of corneal ulcer caused by microbial infection were treated by combined operation,The effective number is 9,The effective rate was 81.82 per cent;Corneal ulcer caused by mechanical injury combined with surgery in 28 patients,The effective number is 26,The effective rate was92.86%;The corneal ulcer caused by chemical burning was combined with surgery in 3 cases,The effective number is 3 cases,The effective rate was 100.00%;Corneal ulcers caused by dry eye(2cases)and corneal foreign body(6 cases)were combined with surgical treatment in 4 cases,The effective number is 4,The effective rate was 100.00.(3)The effect of drug therapy on superficial corneal ulcer is very good,but when corneal ulcer develops into refractory corneal ulcer,the effective rate of surgical combined drug therapy is significantly higher than that of drug therapy alone.