Doft B M, Kelsey S F, Wisniewski S R
Retina-Vitreous Consultants, Endophthalmitis Vitrectomy Study Data Coordinating Center, 127 Parran Hall, 130 DeSoto St, Pittsburgh, PA 15261, USA.
Arch Ophthalmol. 2000 Dec;118(12):1661-5. doi: 10.1001/archopht.118.12.1661.
To assess the frequency of retinal detachment following postcataract endophthalmitis and to evaluate the results of management of these detachments.
Prospective data collected as part of the Endophthalmitis Vitrectomy Study were analyzed. The study was a randomized clinical trial testing the roles of vitrectomy and intravenous antibiotics in restoring vision in patients with endophthalmitis following cataract surgery.
The incidence of retinal detachment was 8.3% after treatment of endophthalmitis, with no difference in frequency based on whether initial management was vitrectomy or tap biopsy. The frequency of detachment was higher with more virulent organisms, poor presenting visual acuity, an open posterior capsule at presentation, and in patients who required an early additional procedure in the management of their endophthalmitis. Retinal detachment resulted in a poor visual outcome, with only 27% of patients achieving 20/40 final visual acuity compared with 55% of patients who did not develop detachment. Patients who were able to undergo surgery for their detachment had a better result, with 38% achieving 20/40 final visual acuity. Anatomic success after surgical repair of detachment was achieved in 78% of patients.
Retinal detachment is a poor prognostic indicator following endophthalmitis, but surgical repair can salvage excellent vision in a substantial number of patients.
评估白内障术后眼内炎后视网膜脱离的发生率，并评估这些视网膜脱离的治疗结果。
分析作为眼内炎玻璃体切除术研究一部分收集的前瞻性数据。该研究是一项随机临床试验，测试玻璃体切除术和静脉内抗生素在白内障手术后眼内炎患者恢复视力中的作用。
眼内炎治疗后视网膜脱离的发生率为8.3%，根据初始治疗是玻璃体切除术还是穿刺活检，发生率没有差异。毒性更强的病原体、初始视力差、就诊时后囊开放以及在眼内炎治疗中需要早期额外手术的患者，视网膜脱离的发生率更高。视网膜脱离导致视力预后较差，只有27%的患者最终视力达到20/40，而未发生视网膜脱离的患者为55%。能够接受视网膜脱离手术的患者结果更好，38%的患者最终视力达到20/40。78%的患者在视网膜脱离手术修复后获得了解剖学成功。
视网膜脱离是眼内炎后的不良预后指标，但手术修复可以使大量患者挽救良好视力。
