方法：回顾性病例研究。选取2018-12/2020-03就诊于重庆医科大学附属第一医院眼科，病原学检查为阳性、溃疡及浸润深度≤1/2角膜厚度的感染性角膜溃疡患者30例30眼，经常规抗感染治疗3～7d，溃疡无明显好转或者浸润继续加重，采用局部低温等离子消融联合滴眼液治疗，术后随访3～6mo，观察临床效果。

结果：细菌性角膜溃疡患者12例12眼经低温等离子消融联合眼液治疗后，其中11例11眼感染控制，溃疡逐渐愈合； 1例1眼因浸润加重行角膜移植术。真菌性角膜溃疡患者18例18眼经低温等离子消融联合局部抗真菌治疗后，其中13例13眼逐渐愈合，2例2眼在第1次消融后又出现苔被样改变，但病灶面积较前明显收缩，予再次消融治疗后逐渐好转； 3例3眼无效，最终行角膜移植术。治愈患者26例26眼，术后随访3～6mo，感染无复发，角膜遗留斑翳或白斑，真菌感染患者复查共聚焦显微镜未查见菌丝。

结论：对浸润深度≤1/2角膜厚度的感染性角膜溃疡采用低温等离子消融联合药物治疗可有效控制感染、促进愈合、改善视力，且未见明显并发症。

METHODS: Retrospective case study. A total of 30 eyes were selected from 30 patients with infectious corneal ulcer who were admitted to the ophthalmology department of the First Affiliated Hospital of Chongqing Medical University from December 2018 to March 2020. All patients had positive etiological examination and ulcer or infiltration depth ≤1/2 of corneal thickness. Local low-temperature plasma ablation combined with eye drops was applied to the cases whose corneal ulcer did not improve significantly or corneal infiltration continued to worsen after 3-7d of conventional anti-infection treatment. Postoperative follow-up was 3-6mo to observe the clinical effect.

RESULTS: After low-temperature plasma ablation combined with eye drops treatment, the infection in 12 eyes of 12 patients with bacterial corneal ulcer was controlled in 11 eyes of 11 patients and ulcer healed gradually. Keratoplasty was performed in 1 eye due to aggravated infiltration. Among 18 eyes of 18 cases with fungal corneal ulcer receiving low-temperature plasma ablation and combined local antifungal treatment, 13 eyes of 13 cases gradually healed; 2 eyes of 2 patients showed lichen-like changes after the first ablation, but the lesion area was significantly smaller than before and gradually improved after re-ablation treatment; there was no effect in 3 eyes of 3 cases and keratoplasty was finally performed. All the patients were followed up for 3-6mo, 26 eyes of 26 patients were cured and the infection had no recurrence with remaining corneal pannus or leukoplakia. Confocal microscopy did not detect mycelium in cured patients with fungal infection.

CONCLUSION: In this preliminary observation, low-temperature plasma ablation combined with drug therapy can effectively control infection, promote healing and improve visual acuity for infective corneal ulcer with infiltration less than 1/2 corneal thickness, and no obvious complications were observed.