Belazzougui R, Monod S Dupont, Baudouin C, Labbé A
Service d'Ophtalmologie III, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France.
J Fr Ophtalmol. 2010 Jan;33(1):10-5. doi: 10.1016/j.jfo.2009.11.010. Epub 2010 Jan 6.
To analyze the architecture of clear corneal incisions after acute endophthalmitis following cataract surgery using anterior segment OCT (AS-OCT).
Fourteen eyes of 14 patients followed at the Quinze-Vingts National Ophthalmology Hospital for acute endophthalmitis following cataract surgery, between April and November 2008, were included in this study. All patients had a complete biomicroscopic examination and a Visante-OCT (Carl Zeiss Meditec AG) analysis of the corneal incision. The length, size (width), location, angle, architecture, and anatomic imperfections of the incisions were analyzed.
Symptoms occurred 4+/-2.4 days after cataract surgery. The location of the incision was superior in 71.43% of cases, temporal in 21.43% and nasal in 7.14%. Incision size (width) was 3.2 mm in 42.86% of cases, 2.75 mm in 35.71%, and 3 mm in 21.43%. Two incisions were sutured (14.28%). Using AS-OCT, the mean incision length was 1.42+/-0.25 mm and the mean incision angle was 39+/-10.62 degrees . Three-step incisions were found in 35.71% of cases and endothelial gaping was found in 42.86 % of cases.
A reduced incision length and inappropriate construction seemed to be determinant risk factors of endophthalmitis following cataract surgery. Other studies using a greater number of patients with an architectural analysis of clear corneal incisions are necessary to confirm these preliminary results.
使用眼前节光学相干断层扫描（AS - OCT）分析白内障手术后急性眼内炎患者透明角膜切口的结构。
纳入2008年4月至11月间在巴黎万森纳国家眼科医院随访的14例白内障手术后发生急性眼内炎患者的14只眼。所有患者均进行了完整的生物显微镜检查及使用Visante - OCT（卡尔·蔡司医疗技术股份公司）对角膜切口进行分析。分析了切口的长度、大小（宽度）、位置、角度、结构及解剖缺陷。
白内障手术后4±2.4天出现症状。71.43%的病例切口位于上方，21.43%位于颞侧，7.14%位于鼻侧。42.86%的病例切口大小（宽度）为3.2mm，35.71%为2.75mm，21.43%为3mm。2个切口进行了缝合（14.28%）。使用AS - OCT，平均切口长度为1.42±0.25mm，平均切口角度为39±10.62度。35.71%的病例发现为三步切口，42.86%的病例发现有内皮裂开。
切口长度缩短及结构不当似乎是白内障手术后眼内炎的决定性危险因素。需要其他更多患者的研究对透明角膜切口进行结构分析以证实这些初步结果。
