Objective::To analyze the clinical and etiological characteristics of patients with fungal keratitis secondary to infectious endophthalmitis who required evisceration.Methods::In this retrospective case series study, a total of 44 patients (44 eyes) who were diagnosed with fungal keratitis secondary to infectious endophthalmitis and underwent evisceration from January 2012 to December 2021 were collected in Shandong Eye Hospital. The course of the disease and its predisposing factors, ocular and systemic history, clinical manifestations, microbial culture and drug sensitivity test results were analyzed.Results::The 44 patients included accounted for 2.15% of the total cases of fungal keratitis diagnosed by Shandong Eye Hospital in the same period. The median course of the disease was 18.5 days. At admission, 44 eyes had no light perception, and 20 eyes (45%) were complicated with secondary glaucoma. All 44 eyes showed corneal ulcer, involving the whole corneal layer and limbus, and 27 eyes (61%) complicated with anterior chamber empyema. A total of 39 eyes (89%) of microbial culture had fungal growth, including 20 eyes (51%) of Fusarium, 8 eyes (21%) of Aspergillus, 2 eyes (5%) of Alternaria, others including 4 eyes (10%) of Nonsporulating molds, 2 eyes (5%) of Pythium insidiosum, 1 eye (3%) of Scedosporium apiospemum, 1 eye (3%) of Sarocladium, 1 eye (3%) of Phialemoniopsis pluriloculosa. The geometric mean of the minimum inhibitory concentration values of amphotericin B, posaconazole, voriconazole, itraconazole, 5-fluorocytosine, fluconazole, anifensin, micafungin and caspofungin cultivated in this study were 1.597, 1.338, 1.926, 3.291, 64, 189.699, 1.36, 1.16, 1.23 μg/ml.Conclusions::The patients with infectious endophthalmitis secondary to fungal keratitis often present with total corneal ulceration. In addition to the common pathogenic bacteria of Fusarium, Aspergillus and Alternaria, other bacteria with strong pathogenicity and invasiveness such as Nonsporulating molds, Pythium insidiosum and Scedosporium apiospemum are also common.

Objective To analyze composition,distribution and characteristics of corneal and conjunctival tumors. Methods Clinical data,including patient ages,locations and pathological types of corneal and conjunctival tumors,were collected from 226 patients treated in our hospital between 2011 and 2017 and were analyzed retrospectively.Results Av-erage age is 29.7.Onset of malignant tumor is earlier than that of benign tumors and the difference was significant(t =-10.241,P <0.001).Malignant tumor is more likely to be found in older patients(≥40 years old).There is no differ-ence in the course of the disease between the two groups(Z=-0.618,P =0.537).The most common location is scleral margin(98 cases;43.36%), followed by conjunctiva(68 cases; 30.09%).Locations with highest rate of malignant tumors are fornix conjunctiva(33.3%), followed by cornea(25%), conjunctiva(15.4%), limbus(13.3%), inner canthus(12.5%), and bulbar conjunctiva(4.4%).Benign tumors are found in 202 cases(89.4%)and malignant tumors in 24 cases(10.6%).The most common benign tumors are dermoid tumor(65 cases;32.2%),followed by cysts (43 patients;21.3%), pigmented nevi(21 cases; 10.4%).Intraepithelial neoplasia is the most common malignant tumor that is found in 15 cases(62.5%),followed by carcinoma in situ(4 cases;16.7%),lymphoma and squamous cell carcinoma(2 cases each,8.3%).Conclusions Our findings showed that different corneal and conjunctival tumors have their own clinical and pathological features.Benign tumors and tumors of the limbus margin are the most common type. Fornical conjunctiva is the location where the highest rate of malignant tumor is found.These observations are useful in guiding clinical diagnosis for corneal and conjunctival tumors.

自1999年8月至2002年7月我院采取会阴侧切向断全层褥式缝合术,术后48h拆线,取得满意效果,现报告如下.