中文摘要：

目的分析非外伤性角膜穿孔的原发病，为积极治疗原发病预防角膜穿孔的发生提供帮助。方法对山东省眼科研究所1997年1月至2007年6月间377例非外伤性角膜穿孔住院患者（383只眼）的病历资料进行回顾性分析，观察角膜穿孔的原发病。结果感染性角膜病是导致角膜穿孔最多见的原发病。其中，单纯疱疹病毒性角膜炎（herpessimplex keratitis，HSK）最多（145例，37．9％），其次为真菌性角膜炎（95例，24．8％），再次为细菌性角膜炎（52例，13．6％）。8只眼发生2次角膜穿孔，原发病分别为HSK（4例）、Mooren溃疡（2例）、坏死性角巩膜炎与细菌性角膜炎各1例。33只眼为角膜移植术后植片穿孔，植片穿孔的原因依次为植片自溶（10例，30．3％）、HSK复发（8例，24．3％）、植片细菌感染（6例，18．2％）、免疫排斥（4例，12．1％）、Mooren溃疡复发（4例，12．1％）与真菌性角膜炎复发（1例，3．0％）。结论感染性角膜病是导致角膜穿孔最多见的原发病。其中HSK与真菌性角膜炎分别居于首位与第2位。1只眼多次发生角膜穿孔的原发病中，HSK与Mooren溃疡常见。植片自溶与HSK复发是角膜移植术后角膜再次穿孔的常见原因。

英文摘要：

Objective To analyze primary diseases of nontraumatic corneal perforation.hoping for help prevention of corneal perforation. Methods Records of 377 inpatients （383eyes） with corneal perforation in Shandong Eye Institute from January 1997 to June 2007 were retrospectively analyzed, with primary diseases observed. Results Infectious corneal diseases were the most primary disease of corneal perforation, in which the most pathogens were herpes simplex virus （ 145 cases; 37.9% ）, followed by fungi （95; 24.8% ） and bacteria （52：13.6%）. Corneal perforations occurred twice in 8 eyes, of which the primary diseases were herpes simplex keratitis （HSK, 4 cases）, Mooren＇s ulcer （2）, necrotizing keratitis and scleratitis （ 1 ）, and bacterial keratitis （ 1 ）. The implanted corneas perforated in 33 eyes, in which causes of perforation included implants autoproteolysis （ 10 cases; 30.3% ）, HSK recurrence （8; 24.3% ）.bacterial infections （6; 18,2% ）, immunological rejection （4; 12.1%）, recurrence of Mooren＇s ulcer （4; 12.1%）, and fungal recurrence （ 1 ; 3.0% ）. Conclusions Infectious corneal diseases are the predominating primary diseases of corneal perfora- tions, of which HSK and fungal keratitis are in the first and second place, respectively. In the same eyes with repeated perforation, HSK and Mooren＇s ulcers are common primary diseases. Implants autoproteolysis and HSK recurrence are the main causes of graft perforation after keratoplasty.