AIM: To investigate the efficacy of lamellar keratoplasty(LKP)combined with accelerated(45mW/cm²)corneal cross-linking(A-CXL)on refractory fungal corneal ulcer.

METHODS: Eighteen eyes of 18 patients with refractory fungal corneal ulcer were enrolled in the Department of Ophthalmology, First Affiliated Hospital of Jiangxi Medical College from January 2017 to November 2018. The postoperative visual acuity, corneal graft transparency, the incidence and prognosis of complications such as fungal recurrence, graft rejection, secondary glaucoma and complicated cataract were all recorded.

RESULTS: All the patients succeeded in avoiding enucleation or evisceration. Postoperatively, 16 eyes(89%)gained one or more lines in uncorrected distance visual acuity 2 eyes(11%)had unchanged in uncorrected distance visual acuity. Three eyes(17%)had a graft rejection. Secondary glaucoma were detected in 2 eyes(11%), and concomitant cataract were found in 3 eyes(17%). Thirteen eyes(72%)had transparent grafts, 4 eyes(22%)had translucent transects, and the remaining one eye(6%)had a turbid graft.

CONCLUSION: LK combined with A-CXL may be feasible for refractory fungal corneal ulcer treatment by improving the cure rate.