Retrospective Analysis Of358Cases Of Fungal Keratitis

Objective To retrospectively analyse the epidemiological characteristics anddiagnostic，therapeutical and prognostic featrues of358cases of hospitalized fungalkeratitis in WuHan Union Hospital.Methods Collect the hospitalized keratitis patients of Union Hospital Affiliated toTongji Medical College, Huazhong University of Science and Technology,betweenJanuary2005to March2012, and then retrospectively analyse the epidemiologicalcharacteristics, clinical diagnosis and treatment outcome of the patients with fungalkeratitis.Results There are358cases of fungal keratitis, accounted high proportion (38.9%),in920cases of keratitis patients.Corneal injury (52.79%), especially vegetable trauma isthe most important risk factor of the disease. In our region, the fungal keratitis mainlyoccurs in the elderly population of the rural areas, the majority (37.7%) aged50-60years old, with a high incidence in autumn and winter, and the incidence of hospitaladmissions showed a tendency to increase year by year. The corneal scraping is mainmethod for diagnosis of fungal keratitis in our hospital, with positive rate of74.9%.Antifungal agent is the most major therapy for fungal keratitis, and the efforts of surgical intervention is gradually increased, the major surgery is lamellar keratoplastyand amniotic membrane transplantation for the treatment of fungal keratitis in ourdepartment. After treating,111cases (31.0%)had clinical healing,236cases(65.92%)had clinical improvement, and treatment of11patients had no effect.50cases werecured by antifungal agents,29cases were healing by lamellar keratoplasty,10caseswere charmed away by amniotic membrane transplantation,18cases weretraumatically cured by evisceration and enucleation, four cases were cured by theother therapy.Conclusion The corneal trauma is the main causative factors of fungal keratitis. Thecorneal scraping is a fast and efficient diagnostic way of fungal keratitis, with highpositive rate in our department. Antifungal treatment is still occupied leading positionin the undergraduate room,however the keratoplasty and amniotic membranetransplantation for the treatment of fungal keratitis efforts to gradually increase andhave being good treatment effect. It is obvious that early diagnosis and standardtreatment is significant factor for prognosis of the fungal keratitis, it isrecommendation that we should carry out surgical intervention as early as possibleunder ineffective treatment by the antifungal drug treatment.