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Full-thickness conjunctival flap covering surgery combined with amniotic membrane transplantation for severe fungal keratitis

  • Authors:
    • Jing Zhong
    • Bowen Wang
    • Saiqun Li
    • Yuqing Deng
    • Haixiang Huang
    • Ling Chen
    • Jin Yuan
  • View Affiliations / Copyright

    Affiliations: State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat‑Sen University, Guangzhou, Guangdong 510060, P.R. China
    Copyright: © Zhong et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Pages: 2711-2718
    |
    Published online on: January 17, 2018
       https://doi.org/10.3892/etm.2018.5765
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Abstract

Fungal keratitis is a severe and common ocular infectious disease. The present study evaluated the efficiency of full‑thickness conjunctival flap covering surgery with amniotic membrane transplantation (FCCS + AMT) as a transitional surgery for severe fungal keratitis. A total of 17 patients with severe fungal keratitis without corneal perforation underwent FCCS + AMT between January 2010 and December 2015. The pathogenic factors, preoperative diagnosis and postoperative prognosis of FCCS + AMT at 3 months were evaluated. Subsequently, 7 patients received sclerokeratoplasty, and the best‑corrected visual acuity (BCVA) and recurrence ratio were analyzed at 1 month postoperatively. The primary risk factor was agricultural trauma (7 cases), followed by a non‑agricultural object entering the eye (3 cases). Preoperatively, there were 10 cases of fungal keratitis positively identified using confocal microscopy and 9 cases positively identified by corneal scrapings. A total of 3 months following FCCS + AMT, the percentage of cases resulting in preservation of the eyeball was 88.24%, with 15/17 patients demonstrating complete conjunctival re‑epithelization and a smooth conjunctival surface without any complications. A total of 2 (11.76%) patients experienced melting of the conjunctival flap and development of endophthalmitis, and subsequently underwent ocular evisceration surgery. A total of 7 patients underwent sclerokeratoplasty and the mean logarithm of the minimum angle of resolution BCVA at 1 month was significantly improved (0.689±0.121; P<0.001) compared with preoperative values (2.459±0.037) and BCVA values following FCCS + AMT (2.529±0.066). No recurrence was observed in any of the cases during the follow‑up period. Conclusively, FCCS + AMT may be a preferable treatment for severe fungal keratitis of the entire corneal ulcer without perforation, and may save the eyeball and provide a greater opportunity for corneal transplantation.
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Copy and paste a formatted citation
Spandidos Publications style
Zhong J, Wang B, Li S, Deng Y, Huang H, Chen L and Yuan J: Full-thickness conjunctival flap covering surgery combined with amniotic membrane transplantation for severe fungal keratitis. Exp Ther Med 15: 2711-2718, 2018.
APA
Zhong, J., Wang, B., Li, S., Deng, Y., Huang, H., Chen, L., & Yuan, J. (2018). Full-thickness conjunctival flap covering surgery combined with amniotic membrane transplantation for severe fungal keratitis. Experimental and Therapeutic Medicine, 15, 2711-2718. https://doi.org/10.3892/etm.2018.5765
MLA
Zhong, J., Wang, B., Li, S., Deng, Y., Huang, H., Chen, L., Yuan, J."Full-thickness conjunctival flap covering surgery combined with amniotic membrane transplantation for severe fungal keratitis". Experimental and Therapeutic Medicine 15.3 (2018): 2711-2718.
Chicago
Zhong, J., Wang, B., Li, S., Deng, Y., Huang, H., Chen, L., Yuan, J."Full-thickness conjunctival flap covering surgery combined with amniotic membrane transplantation for severe fungal keratitis". Experimental and Therapeutic Medicine 15, no. 3 (2018): 2711-2718. https://doi.org/10.3892/etm.2018.5765
Copy and paste a formatted citation
x
Spandidos Publications style
Zhong J, Wang B, Li S, Deng Y, Huang H, Chen L and Yuan J: Full-thickness conjunctival flap covering surgery combined with amniotic membrane transplantation for severe fungal keratitis. Exp Ther Med 15: 2711-2718, 2018.
APA
Zhong, J., Wang, B., Li, S., Deng, Y., Huang, H., Chen, L., & Yuan, J. (2018). Full-thickness conjunctival flap covering surgery combined with amniotic membrane transplantation for severe fungal keratitis. Experimental and Therapeutic Medicine, 15, 2711-2718. https://doi.org/10.3892/etm.2018.5765
MLA
Zhong, J., Wang, B., Li, S., Deng, Y., Huang, H., Chen, L., Yuan, J."Full-thickness conjunctival flap covering surgery combined with amniotic membrane transplantation for severe fungal keratitis". Experimental and Therapeutic Medicine 15.3 (2018): 2711-2718.
Chicago
Zhong, J., Wang, B., Li, S., Deng, Y., Huang, H., Chen, L., Yuan, J."Full-thickness conjunctival flap covering surgery combined with amniotic membrane transplantation for severe fungal keratitis". Experimental and Therapeutic Medicine 15, no. 3 (2018): 2711-2718. https://doi.org/10.3892/etm.2018.5765
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