白内障术后感染性眼内炎的治疗方法以及易感因素
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Treatment and predisposing factors of postcataract endophthalmitis after phacoemulsification operation
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    摘要:

    目的:探讨白内障术后感染性眼内炎的治疗方法以及易感因素。

    方法:回顾性分析2003-06/2013-06在我院确诊为白内障术后感染性眼内炎的患者8例8眼。所有患者均行手术治疗。术前均常规抽取房水及玻璃体液送细菌、真菌培养加药物敏感试验,观察分析患者病原菌及药敏情况,手术前后视力、术后感染控制情况及有无并发症等情况。

    结果:术后随访6~12mo,8例患者手术后1,6mo视力与手术前视力比较显著提高,差异有统计学意义(P<0.05); 所有患者术后眼内炎症均得以控制,无1例出现术后并发症。8例患者中有7例检测到致病菌,其中4例为表皮葡萄球菌感染,3例为粪肠球菌D群感染; 两种致病菌均对万古霉素敏感。易感因素有:高龄、糖尿病、慢性阻塞性肺病、肾功能衰竭、结核。

    结论:尽早行前房冲洗联合玻璃体腔注药术或者玻璃体切割术联合玻璃体腔注药术均能够有效治疗感染性眼内炎。万古霉素是有效的抗菌药物。

    Abstract:

    AIM: To study the treatment and predisposing factors of postcataract endophthalmitis after phacoemulsification operation.

    METHODS: The clinical data of 8 patients(8 eyes)with postcataract endophthalmitis were analyzed retrospectively from June 2003 to June 2013. Emergent surgery(anterior chamber irrigation, vitrectomy, intravitreal injection)was performed in all patients. Aqueous fluid and vitreous purulence was taken in all patients before vitrectomy for bacterial, fungal culture and drug sensitivity test. The preoperative and postoperative visual acuity, inflammatory reaction and postoperative complications were observed.

    RESULTS: All the patients were followed up for 6-12mo.The visual acuity improved significantly at l, 6mo after surgery(P<0.05). Endophthalmitis was controlled in all of eyes after surgery, and no one case had postoperative complications. Seven cases was isolated pathogens, and the main bacteria spectrum of postcataract endophthalmitis was staphylococcus epidermidis and enterococcus faecalis(D group).The two kinds of bacteria were sensitive to vancomycin. The predisposing factors included: advanced age, diabetes, chronic obstructive pulmonary disease, renal failure, tuberculosis.

    CONCLUSION: For postcataract endophthalmitis, vitrectomy as early as possible could improve the prognosis and performing the surgery of vitrectomy is effective for postcataract endophthalmitis. Vancomycin is effective antibacterials.

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王燕,庞龙,欧扬,等.白内障术后感染性眼内炎的治疗方法以及易感因素.国际眼科杂志, 2014,14(5):956-958.

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  • 收稿日期:2014-01-14
  • 最后修改日期:2014-04-14
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  • 在线发布日期: 2014-04-21
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