目的：探讨角膜病灶板层切除联合胶原交联手术治疗浅层真菌性角膜炎的临床效果。

方法：回顾性分析。纳入2014-01/2023-10来我院行角膜病灶板层切除联合胶原交联手术的浅层真菌性角膜炎患者79例79眼。入院后常规抗真菌药物治疗7 d病情无明显好转或进行性加重。所有患者的角膜病灶最大直径均≤7 mm，最大深度均不超过所在位置50%角膜厚度且剩余健康角膜厚度≥300 μm，随访时间90-112 d。

结果：纳入79眼中，病灶位于角膜中央区者6眼，旁中央区者61眼，周边区者12眼，其中5眼同时合并前房积脓。79眼均成功实施角膜病灶板层切除联合胶原交联术，76眼(96%)治愈，3眼(4%)失败。治愈眼的角膜上皮愈合时间为3-15 d，其中51眼(67%)在7 d内愈合，24眼(32%)在3 d内愈合。末次随访时76眼治愈患者UCVA、BCVA与术前相比均有差异(P<0.0167)。手术失败3眼中有2眼位于病灶边缘处，再次行角膜病灶板层切除术后痊愈； 1眼位于病灶中央处，改行球结膜瓣遮盖后痊愈。末次随访时，所有患者除病灶处角膜遗留浅层云翳、角膜变薄以外，未见其他并发症。

结论：角膜病灶板层切除联合胶原交联手术治疗浅层真菌性角膜炎快速、有效，可以作为一种新的治疗选择。

METHODS: Retrospective analysis. Totally 79 patients(79 eyes)with superficial fungal keratitis who underwent LKCCC in our hospital from January 2014 to October 2023 were included. After admission, routine antifungal drug treatment for 7 d showed no obvious improvement or progressive aggravation. The maximum diameter of corneal lesions in all patients was ≤7 mm, the maximum depth was no more than 50% of the corneal thickness at the location, and the remaining healthy corneal thickness was ≥300 μm. The follow-up time was 90 to 112 d.

RESULTS:Among the included 79 eyes, the lesions were located in the central region of the cornea in 6 eyes, in the paracentral region in 61 eyes, and in the peripheral region in 12 eyes. Hypopyon was observed in 5 cases. LKCCC was successfully administered in 79 eyes, cured in 76 eyes(96%), and failed in 3 eyes(4%). The healing time of corneal epithelium in 76 cured eyes was 3-15 d, of which 51 eyes(67%)healed within 7 d and 24 eyes(32%)healed within 3 d. The uncorrected visual acuity(UCVA)and best corrected visual acuity(BCVA)of 76 eyes of cured patients were statistically significant compared with those preoperatively(P<0.0167). Two of the 3 failed eyes were located at the edge of the lesion and recovered after re-keratectomy. One eye was located in the center of the lesion and recovered after being covered by bulbar conjunctival flap. At the last follow-up, no other complications were observed in all patients except superficial cloud and thinning of cornea.

CONCLUSION:LKCCC is a rapid and effective treatment for superficial fungal keratitis and can be considered a new treatment option.