Comparative analysis of the therapeutic efficacy of low-temperature plasma ablation in treating fungal keratitis caused by various strains.

Abstract

Objective: The objective of this study is to assess the therapeutic efficacy of low-temperature plasma ablation (LTP) combined with drug treatment in the treatment of fungal keratitis (FK) caused by various pathogens, thereby establishing a clinical foundation for the use of LTP in treating FK.

Methods: A retrospective study was performed, including 76 patients (76 eyes) with FK diagnosed at the Affiliated Eye Hospital of Nanchang University. The patients were categorized into the Fusarium group, Alternaria group, Aspergillus group, and other genus groups based on positive results from biological cultures. Key clinical parameters, including best-corrected visual acuity (BCVA), maximum ulcer lesion diameter, and healing grades, were assessed and compared at baseline (pre-treatment), on postoperative day 3, and at postoperative week 3.

Results: The study demonstrated that the BCVA (LogMAR) of all patients revealed no significant differences at postoperative day 3 (F = 2.54, p = 0.063) and week 3 (F = 1.86, p = 0.143). Although BCVA improved to varying degrees compared to preoperative levels, the changes were not statistically significant (p > 0.05). After treatment with LTP combined with pharmacotherapy across all four groups, an average of 53 patients (69.74%) achieved grade I healing, with the group effect being nonsignificant (F = 2.85, p = 0.071), while the effect of time post-treatment was significant (F = 67.85, p < 0.001). Additionally, the corneal scar diameter at postoperative week 3 was significantly smaller compared to the preoperative lesion diameter (p < 0.05). Multiple comparisons revealed significant differences in scar diameter among patients with grade I healing at postoperative week 3 (F = 3.48, p = 0.023), with notable differences observed between the Alternaria and Fusarium groups (p = 0.017). The average rate of grade III healing, defined by the occurrence of corneal perforation and/or the need for therapeutic penetrating keratoplasty, was 7.89%.

Conclusion: Low-temperature plasma ablation demonstrates effective therapeutic outcomes for FK caused by various pathogens that are unresponsive to pharmacological treatments, with no significant complications.