Wejde G, Samolov B, Seregard S, Koranyi G, Montan P G
St Erik's Eye Hospital, Stockholm S-112 82, Sweden.
J Hosp Infect. 2005 Nov;61(3):251-6. doi: 10.1016/j.jhin.2005.04.016.
To gain further knowledge of possible risk factors for the development of postoperative endophthalmitis (POE) following cataract surgery, a single-centre retrospective case-control study was conducted for 1994-2000. In total, 46292 cataract procedures were performed during the study period. Sixty cases of POE were noted and 240 control cases were selected at random. Parameters pertaining to patient history and to peri-operative technique and complications were analysed. The relative risk of POE was calculated using univariate analyses and multi-variate forward stepwise logistic regression. In the logistic regression analyses, three statistically significant parameters were found. The use of intracameral prophylaxis with cefuroxime as opposed to topical treatment alone, and performing phaco-emulsification instead of extra- or intracapsular cataract extraction appeared to be protective against POE. Silicone intra-ocular lenses carried a higher risk than heparin surface modified poly (methyl methacrylate) implants. In summary, the important finding of this study was the protective effect against POE of intracameral prophylaxis with cefuroxime compared with topical anti-infectives alone.
为了进一步了解白内障手术后发生术后眼内炎(POE)的可能危险因素,于1994年至2000年进行了一项单中心回顾性病例对照研究。在研究期间共进行了46292例白内障手术。记录到60例POE病例,并随机选择240例对照病例。分析了与患者病史、围手术期技术及并发症相关的参数。使用单因素分析和多因素向前逐步逻辑回归计算POE的相对风险。在逻辑回归分析中,发现了三个具有统计学意义的参数。与仅采用局部治疗相比,使用头孢呋辛进行前房内预防以及采用超声乳化术而非囊外或囊内白内障摘除术似乎对POE具有保护作用。硅胶人工晶状体比肝素表面改性聚甲基丙烯酸甲酯植入物具有更高的风险。总之,本研究的重要发现是,与单独使用局部抗感染药物相比,使用头孢呋辛进行前房内预防对POE具有保护作用。