The effect of laser photocoagulation on the hyphal structure of fungal corneal ulcer detected by using fluorescein staining

Abstract

Objective To observe the effect of laser photocoagulation on the hyphal structure of fungal corneal ulcer by using fluorescein staining. Methods A prospective research of 28 patients (28 eyes) diagnosed as Fungal Keratitis by using confocal laser corneal microscopy were followed up, who recruited from January 2016 to August 2016 in our hospital. Among them 19 males (19 eyes) and 9 females (9 eyes) with age ranging from 24 to 63, averages (44.00±0.00) years old. The average onset time was from 3 to 18 days, averaged (9.00±0.00) days. And hypopyon were observed in 9 cases (9 eyes). Besides topical anti-fungal Fluconazole Eye Drops and Natamycin Eye Drops, all patients also received fluorescein staining and laser photocoagulation under topical anesthesia for their cornea. Meanwhile, in vivo confocal laser-scanning microscopy were used to detect the positioning location, scope and structure changes after laser surgery of the fungal hyphae. Results Laser photocoagulation on the hyphal structure of fungal corneal ulcer detected by using fluorescein staining. Laser photocoagulation on the hyphal structure of fungal corneal ulcer detected by using fluorescein staining. Fungal corneal ulcer in the 28 patients (28 eyes) were all under control after the laser photocoagulation detected by using fluorescein staining. And hypopyon were decreased gradually in the 9 patients. After laser photocoagulation, the fungal mycelium structure in the ulcer was broken and melted detected by Confocal laser corneal microscopy. Noulcer recurrence was observed in 3 to 6 months after the follow-up. Conclusions Laser photocoagulation detected by using fluorescein staining leads to structural breakdown of the fungal hyphae of Fungal Keratitis. Confocal laser corneal microscopy is helpful to detect the positioning location, scope and structure changes after laser surgery of the fungal hyphae. Therefore, it is a safe, effective and precise way for the treatment of Fungal Keratitis. Key words: Fungus; Corneal ulcer; Confocal laser corneal microscopy; Laser photocoagulation