Kehdi Elias E, Watson Stephanie L, Francis Ian C, Chong Robert, Bank Allan, Coroneo Minas T, Dart John K
Department of Ophthalmology, Prince of Wales Hospital, Sydney, Australia.
J Cataract Refract Surg. 2005 Sep;31(9):1702-6. doi: 10.1016/j.jcrs.2005.02.033.
To describe the presentation, management, and outcome of 5 patients who presented with main-port or side-port wound infection after uneventful clear corneal cataract surgery.
Ophthalmic Surgery Centre, Chatswood, and Department of Ophthalmology, Prince of Wales Hospital, Randwick, Australia, and Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom.
This retrospective case series comprised 5 patients who had uneventful clear corneal phacoemulsification surgery and developed either a main-port or side-port wound infection. The clinical features, microbiologic studies, management, and results are reported.
The median age of the patients was 79 years. Infection of the main-port incision occurred in 3 cases and of the side port in 2 cases. The patients presented from a few days to several weeks after uneventful phacoemulsification. In 2 cases, the bacteria Pseudomonas aeruginosa and Staphylococcus aureus were isolated. In 1 case, the fungus Aspergillus was isolated and required extensive medical and surgical treatment. In the other 2 cases; empiric antimicrobial therapy was given because no organism was isolated in 1 case, and in the other milder case, microbiological investigations were not performed. Final visual acuity was 6/4 in 2 cases and 6/5, 6/12, and 6/18 in 1 case each.
Bacterial or fungal wound infection can present within days or even several weeks following clear corneal cataract surgery. Patients with ocular discomfort or blurred vision after such surgery should be advised to report promptly. Rapid identification and appropriate management of patients with clear corneal wound infection can result in good visual outcomes.
描述5例在顺利完成透明角膜白内障手术后出现主切口或侧切口伤口感染患者的临床表现、治疗及预后。
澳大利亚查茨伍德眼科手术中心、威尔士亲王医院眼科（位于兰德威克）以及英国伦敦摩尔菲尔德眼科医院国民保健服务信托基金。
本回顾性病例系列研究纳入5例顺利完成透明角膜超声乳化手术并发生主切口或侧切口伤口感染的患者。报告其临床特征、微生物学研究、治疗及结果。
患者的中位年龄为79岁。主切口感染3例，侧切口感染2例。患者在顺利完成超声乳化手术后数天至数周出现症状。2例分离出铜绿假单胞菌和金黄色葡萄球菌。1例分离出曲霉菌，需要广泛的药物和手术治疗。另外2例，1例因未分离出病原体给予经验性抗菌治疗，另1例病情较轻未进行微生物学检查。最终视力2例为6/4，另3例分别为6/5、6/12和6/18。
透明角膜白内障手术后数天甚至数周内可发生细菌或真菌性伤口感染。此类手术后出现眼部不适或视力模糊的患者应被告知及时报告。对透明角膜伤口感染患者进行快速识别和适当治疗可取得良好的视力预后。
