Infection and Drug Resistance (Mar 2023)
Clinical Observation of Low-Temperature Plasma Ablation Combined with Drug Therapy in the Treatment of Fungal Keratitis
Abstract
Tao Sun,1– 4 Bo-Wen Zhang,1– 4 Rui Xiong,1– 4 Wen-Tian Zhou,1– 4 Jing-Jing Qiu5 1Affiliated Eye Hospital of Nanchang University, Nanchang, Jiangxi, 330006, People’s Republic of China; 2Jiangxi Clinical Research Center for Ophthalmic Disease, Nanchang City, Jiangxi Province, 330006, People’s Republic of China; 3Jiangxi Research Institute of Ophthalmology and Visual Science, Nanchang City, Jiangxi Province, 330006, People’s Republic of China; 4Jiangxi Provincial Key Laboratory for Ophthalmology, Nanchang City, Jiangxi Province, 330006, People’s Republic of China; 5Department of Ophthalmology of The Second Affiliated Hospital of Nanchang University, Nanchang City, Jiangxi Province, 330006, People’s Republic of ChinaCorrespondence: Jing-Jing Qiu, Department of Ophthalmology of The Second Affiliated Hospital of Nanchang University, No. 1, Minde Road, Nanchang City, Jiangxi Province, 330006, People’s Republic of China, Tel +86 15070001118, Email [email protected]: To observe the efficacy and prognosis of low-temperature plasma ablation + drug therapy in the treatment of fungal corneal ulcers.Methods: The present paper presents a retrospective clinical study with a subject base of 34 eyes. Patients with a fungal corneal ulcer who visited the Affiliated Eye Hospital of Nanchang University between August 2019 and December 2021 were selected as the study participants. They were found to have highly reflective fungal hyphae in the corneal stroma layer via confocal microscope examination, which were revealed to be positive on etiology examination, with the ulcer and infiltration depths ≤ 1/2 of the corneal thickness. The efficacy and prognosis were observed after treatment with low-temperature plasma ablation + drug therapy.Results: A total of 34 cases (34 eyes) had clinical manifestations of corneal infiltration and corneal ulcer formation, with a corneal lesion diameter of 1.31– 8.64 mm (average = 4.79 ± 2.03 mm). The average healing time of corneal ulcers was 6.2 ± 1.7 days. Among a total of 34 cases (34 eyes) in patients with fungal keratitis, the infection was controlled and the ulcers gradually healed after treatment with low-temperature plasma system + drug therapy in a total of 30 cases (30 eyes, 88%). A total of three cases (3 eyes, 9%) exhibited no clear improvement after the treatment, and the patients underwent conjunctival flap covering surgery. One case (one eye, 3%) exhibited no clear improvement after further treatment, with the patient experiencing corneal perforation and ultimately undergoing penetrating keratoplasty.Conclusion: Low-temperature plasma ablation + drug therapy can effectively control the progression of fungal keratitis infection, as well as significantly shorten the ulcer healing time, and is, therefore, an effective method.Keywords: low-temperature plasma, keratitis, fungal infection, antimicrobial therapy, ophthalmic surgery
