| objective: we investigate the effect of lesions debridement combined with corneal stroma injection of nano-Ag on the treatment of moderate to severe fungal corneal ulcer,by establishing animal model of fungal corneal ulcer in rabbits.Methods: a concentration of 5x107(colony forming units,CFU)/ml standard Aspergillus fumigatus solution was prepared,60 adults Japanese white rabbits were randomly divided into two groups and marked,corneal stroma injection of Aspergillus fumigatus group(group a n =54),corneal stroma injection of sterile saline group(group b n=6),all animals were selected for the left eye as the experimental eye.Group a with a insulin syringe(with 30 gauge needle),the left corneal stroma injection of 1u containing standard Aspergillus fumigatus suspension(forming a diameter of about 2mm plaque),group b injected with equal saline by the same way.After inoculation,4 u dexamethasone sodium phosphate injection was injected into the lower dome for conjunctiva.After 48 hours,the test was performed by slit lamp microscopy,10% KOH smear,fungal culture and confocal microscopy.Three concentration of 250μg/ml,500μg/ml,750μg/ml of nano-Ag solution and 500μg/ml voriconazole solution were placed.Selection of standard animal models 54 rabbits were randomly divided into five groups and labeled,250μg/ml nano-Ag treatment group(group A n=12),500μg/ml nano-Ag treatment group(group B n=12),750μg/ml nano-Ag treatment group(group C n=12),500μg/ml voriconazole solution treatment group(group D n=12),sterile saline group(group E n=6).After local debridement of the corneal ulcer and iodine burning on group A-E,the corresponding reagents were injected into the corneal stroma with insulin syringes(30 needle),a total of about 4u.Group E were injected the same amount of sterile saline.The frequency of administration: once every 3 days before 10 days,once every 5 days after 10 days,and once 7 days after 20 days.The corneal ulcer healing was observed before a slit lamp after treatment.Cured rabbits were observed for 3 months to determine the prognosis.Statistical software SPSS17.0 was used for statistical description and inference.Qualitative data were expressed by frequency and percentage.Quantitative data were expressed by mean and standard deviation.Qualitative data between groups were compared using chi-square test,quantitative data between groups were compared using ANOVA,pairwise comparisons between groups with the least significance of difference(LSD)method.The statistical test standard was P<0.05.Results: After 48 hours of modeling,the success rate of group A was 100%,and group B had no corneal infection.After treatment with three different concentrations of nano-Ag(group A,B andC)and 500μg/ml of voriconazole(group D)in the treatment of Aspergillus fumigatus corneal ulcer in rabbit eyes,the total effective rate of group B was the highest,compared with group A,C and E was statistically significant(P <0.05),compared with group D was not statistically significant(P>0.05).The difference of the effective treatment time between group B and group A 、C was statistically significant(P <0.05),and there was no significant difference between group B and group D(P>0.05).Cured rabbits had no recurrence after three months.Conclusion: Corneal stroma injection of Aspergillus fumigatus was established in rabbits with a success rate of 100%.In the three different concentrations of nano-Ag,500μg/ml nano-Ag for moderate to severe Aspergillus fumigatus corneal ulcer had the highest efficiency,and the effective treatment time was the shortest.500μg/ml nano-Ag and 500μg/ml voriconazole solution had a good effect on moderate to severe Aspergillus fumigatus corneal ulcer,the effective treatment time was similar,no corneal toxicity was found,and cured rabbits had no recurrence after three months.Nano-Ag prices are relatively low,less adverse reactions,easy preparation,it may become a new drug for the treatment of moderate to severe fungal corneal ulcers. |
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