Yan Hua, Chen Song, Zhang Jing-kai, Yu Jin-guo, Han Jin-dong
Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin 300052, China.
Zhonghua Yan Ke Za Zhi. 2009 Aug;45(8):684-7.
To explore the effects of vitrectomy combined with silicone oil injection on the treatment of postoperative endophthalmitis following cataract surgery without intraocular lens removal, and to analyze the relative factors.
This was a retrospective case series study. Clinical data of 7 eyes of 7 patients with postoperative endophthalmitis following cataract surgery underwent the treatment of vitrectomy combined with silicone oil injection without intraocular lens removal from 2003 to 2008 were collected. The outcomes of vision, slit lamp examination, direct and indirect ophthalmoscopy, IOP, and B-scan were observed, and the surgical effects were analyzed.
Five patients were male, and 2 patients were female. The age ranged from 67.0 to 84.0 years with a mean of 70.0 + or - 4.5. The onset of endophthalmitis ranged from 1 to 3 days with a mean of 2 days. Silicone oil was removed in 5 eyes 3 to 6 months postoperatively. Preoperative visual acuity ranged from non light perception to hand moving. The mean preoperative intraocular pressure (IOP) was (35.0 + or - 0.5) mmHg with a range from 35.0 to 56.0 mmHg. Follow-up periods ranged from 6 to 43 months with a mean of (10 + or - 6) months. Postoperative visual acuity ranged from non light perception to 0.8. Postoperative vision increased in 6 eyes (86%), and was stable in 1 eye (14%). The mean postoperative IOP was (18.0 + or - 1.5) mmHg with a range from 10.0 to 20.0 mmHg, this was significantly lower than that preoperatively (t = 1.94, P < 0.05). Postoperative complications mainly included fibrous exudates in the anterior chamber at early stage after the surgery (7 eyes) and temporary intraocular pressure elevation (1 eye). There was no retinal detachment and atrophia bulbi.
Vitrectomy combined with silicone oil injection may be a safe and effective method in treating postoperative endophthalmitis following cataract surgery without intraocular lens removal.
探讨玻璃体切除术联合硅油注入术在不摘除人工晶状体的白内障手术后眼内炎治疗中的效果，并分析相关因素。
这是一项回顾性病例系列研究。收集了2003年至2008年7例白内障手术后发生眼内炎且未摘除人工晶状体的患者的7只眼接受玻璃体切除术联合硅油注入术治疗的临床资料。观察视力、裂隙灯检查、直接和间接检眼镜检查、眼压及B超检查结果，并分析手术效果。
男性5例，女性2例。年龄67.0至84.0岁，平均70.0±4.5岁。眼内炎发病时间1至3天，平均2天。5只眼在术后3至6个月取出硅油。术前视力从无光感到手动。术前平均眼压（IOP）为（35.0±0.5）mmHg，范围为35.0至56.0 mmHg。随访时间6至43个月，平均（10±6）个月。术后视力从无光感到0.8。6只眼（86%）术后视力提高，1只眼（14%）视力稳定。术后平均眼压为（18.0±1.5）mmHg，范围为10.0至20.0 mmHg，显著低于术前（t = 1.94，P < 0.05）。术后并发症主要包括术后早期前房纤维渗出（7只眼）和暂时性眼压升高（1只眼）。未发生视网膜脱离和眼球萎缩。
玻璃体切除术联合硅油注入术可能是治疗不摘除人工晶状体的白内障手术后眼内炎的一种安全有效的方法。
