Clinical Analysis On The Surgery Of Refractory Suppurative Keratitis

ObjectiveTo study the therapeutic effect of operation on severe suppurative keratitis and to evaluate the essentiality of early time and in time operation.MethodsWe choosed 61patients(61eyes) with refractory ruppurative keratitis which had been treated for operative therapy at the first affiliated hospital,Chongqing medical university, from Jan.2006 to Dec.2009.Including bacterial infection 35 eyes,fungal infection 20eyes,and mixed infection 6 eyes. 7eyes bad been perforated. 18eyes bad hypopyon exceed 1/3anterior chamber. Regular communicate with patients of post-operation .The follow-up ranged from 3-12months.The preservation of eyeballs, post-operative visual acuity and complications were documented.Results1 56 eyes were preserved after the operation,4eyes enucleated,1eye lost.2 Most patients had a restoration of visual function,.3 Infection recurred in 6 eyes,3 of which were controlled with sencondary operation,the others were enucleated because of the uncontrolled endophthalmitis.4 7eyes occurred secondary glaucoma, the intraocular pressure of 6 eyes was controlled medically and surgically,1eye enucleated for severe pain and complete visual loss. Complicated cataract occurred in 15 eyes.5 Graft rejection was observed in 17 eyes, 3received secondary corneal transplantation,1 eye refused further therapy.Conclusion1 Operation is an effective way for preservation of eyeballs and restoration of visual function in patients eyes with severe suppurative keratitis. Therapeutic keratoplasty especially penetrating keratoplasty may treat severe infectious keratitis effectively.2 High cure rates are achievable and visual acuity is elevated by early time and in time operation on severe suppurative keratitis.3 Amniotic membrane transplantation and conjunctival flap covering surgery are effective in promoting epithelialization and could be performed as an emergent procedure until a donor cornea is available.