Fox G M, Joondeph B C, Flynn H W, Pflugfelder S C, Roussel T J
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine, Florida 33101.
Am J Ophthalmol. 1991 Feb 15;111(2):163-73. doi: 10.1016/s0002-9394(14)72254-8.
We reviewed 19 cases of delayed-onset pseudophakic endophthalmitis in which diagnostic cultures were performed at one month or more after cataract extraction with posterior chamber intraocular lens implantation. We isolated four different organisms in these 19 cases: 12 Propionibacterium species (63%), three Candida parapsilosis (16%), three Staphylococcus epidermidis (16%), and one Corynebacterium species (5%). Because of the unusual delayed-onset features of these cases and the retrospective nature of this study, a variety of treatment regimens were used. Twelve patients had recurrence of marked inflammation despite an apparent initial cure, and ten of these patients had positive culture results on repeat examination of intraocular fluids. Nine patients continued to be treated with topical corticosteroids postoperatively to suppress low-grade inflammation. Of the 19 patients, 16 had final visual acuity of 20/400 or better. Delayed-onset pseudophakic endophthalmitis had a more favorable visual prognosis, compared to acute-onset endophthalmitis.
我们回顾了19例迟发性人工晶状体眼内炎患者，这些患者在白内障摘除联合后房型人工晶状体植入术后1个月或更长时间进行了诊断性培养。在这19例病例中，我们分离出四种不同的微生物：12例丙酸杆菌属（63%）、3例近平滑念珠菌（16%）、3例表皮葡萄球菌（16%）和1例棒状杆菌属（5%）。由于这些病例具有不寻常的迟发性特征以及本研究的回顾性性质，因此采用了多种治疗方案。12例患者尽管最初看似治愈，但仍出现明显炎症复发，其中10例患者再次检查眼内液时培养结果呈阳性。9例患者术后继续接受局部皮质类固醇治疗以抑制低度炎症。19例患者中，16例最终视力达到20/400或更好。与急性人工晶状体眼内炎相比，迟发性人工晶状体眼内炎的视力预后更有利。
