方法：收集2014-01/2016-12在中山大学中山眼科中心海南眼科医院住院治疗的真菌性角膜溃疡确诊病例81例81眼的基本资料。分析致病真菌种群分布特点、患者年龄分布特点、患病季节分布构成比以及疾病危险因素。回顾分析真菌性角膜溃疡治疗方式，计算角膜溃疡坏死组织的真菌培养及鉴定、真菌涂片结果阳性率，卡方检验比较两种实验室检查方法阳性检出率。

结果：选取临床诊断真菌性角膜溃疡患者81例81眼，其中男54眼，女27眼，年龄中位数51岁。角膜外伤是最常见的危险因素。≥50岁患病人数45眼(55%)，占比最大； 其次为>30～<50岁年龄段人群组28眼(35%)； ≤30岁人群组8眼(10%)，占比最小。第一季度是全年真菌性角膜溃疡的高发时段，患病人数占36%。81份真菌培养样本阳性例数71眼，阳性率88%。80份角膜坏死物涂片样本，阳性样本共41眼，阳性率51%。真菌涂片阳性检出率低于真菌培养，差异有统计学意义(χ²=23.730， P<0.01)。主要致病性真菌依次为镰刀菌属34眼(48%)，不产孢子菌11眼(15%)。治疗上均采用了多种抗真菌药物治疗，23眼(28%)联合角膜清创+结膜瓣遮盖术治疗； 9眼(11%)联合角膜移植术； 7眼(9%)联合眼内容物剜除术。

结论：中国海南省本岛真菌性角膜溃疡的最主要致病菌是镰刀菌属、不产孢子菌，高发季节为1～3mo。患者多有角膜外伤史。抗真菌药物及手术治疗是目前真菌性角膜溃疡的主要治疗手段。与真菌涂片相比较，真菌培养具有更高的阳性检出率。

METHODS: Eighty-one patients(81 eyes)with fungal keratitis who attended the Corneal Services of Hainan Province Eye Hospital from January 2014 to December 2016 were retrospectively reviewed. The characteristics of fungal population, the age distributions of patients, the seasonal distribution of disease and the risk factor were analyzed. The treatment of fungal keratitis was reviewed. The positive rates of KOH based smear and fungal culture were assessed and analyzed using the Chi-squared test.

RESULTS: Eighty-one patients of fungal keratitis(including 81 eyes)were involved. The ration of the male and female was 2:1. The median age was 51 years. Corneal trauma seems to be the most common risk factor. Of all cases, 45 patients(55%)were greater than or equal to 50 years old. Twenty-eight(35%)were between 30-50 years old. Eight(10%)were less than or eaqual to 30 years old. Twenty-nine cases(36%)appeared in the first quarter indicated that fungal keratitis was most popular in the winter in Hainan Province. Standard fungal cultures were performed in 81 cases. Seventy-one of the 81 samples(88%)grew fungi. Fungal smear tests were performed in 80 cases. Forty-one cases(51%)were confirmed to be fungal keratitis by 10% KOH count. Statistical differences were found in the positive rates between fungal culture and fungal smear test(χ²=23.730, P<0.01). The predominant fungal species isolated was Fusarium sp. in 34 cases(48%)followed by asporogenous strain in 11 cases(15%). Antifungal drugs were applied in all cases. Conjunctival flap transplantation was performed in 23 cases(28%), penetrating keratoplasty in 9 cases(11%), and evisceration in 7 cases(9%).

CONCLUSION: The predominant fungal species isolated is Fusarium sp. followed by asporogenous strain. The fungal keratitis is most popular in the first quarter in Hainan Island. Corneal trauma seems to be the most common risk factor. Multidisciplinary approach, including the combined application of surgery and antifungal drugs is the treatment strategy common used for the fungal keratitis. The positive rate of fungal culture is higher than fungal smear test.