Manners R M, Canning C R
Eye Hospital, Southampton.
Br J Ophthalmol. 1991 Dec;75(12):710-2. doi: 10.1136/bjo.75.12.710.
A case of posterior lens capsular abscess occurring many months after an extracapsular cataract extraction is presented. This was caused by a mixed infection involving Propionibacterium acnes and Staphylococcus epidermidis. The significance of Staph epidermidis after such a long postoperative period is uncertain, but the case shows features typical of secondary endophthalmitis due to P acnes, including a long delay in onset and a grumbling course not brought under control by medical treatment. It supports the theory that the nidus of infection is localised in the posterior lens capsule by showing development of a visible capsular abscess with associated vitreous involvement. The subsequent removal of the capsule and vitreous, despite leaving the intraocular lens in place, led to complete resolution of the inflammation. Both organisms have previously been found to be sequestered in the posterior lens capsule by histological and microbiological examination of excised capsular specimens. It is important to consider them as possible causative agents in the formation of a postoperative capsular abscess.
本文报告1例在白内障囊外摘除术后数月发生的晶状体后囊膜脓肿病例。这是由痤疮丙酸杆菌和表皮葡萄球菌混合感染所致。术后如此长的时间后表皮葡萄球菌感染的意义尚不确定，但该病例显示出痤疮丙酸杆菌引起的继发性眼内炎的典型特征，包括发病延迟较长且病情进展缓慢，药物治疗无法控制。通过出现可见的囊膜脓肿并伴有玻璃体受累，证明感染病灶定位于晶状体后囊膜，支持了这一理论。随后尽管保留了人工晶状体，但切除了囊膜和玻璃体，炎症完全消退。通过对切除的囊膜标本进行组织学和微生物学检查，先前已发现这两种微生物都隐匿在晶状体后囊膜中。将它们视为术后囊膜脓肿形成的可能病原体很重要。
