Thapa R, Paudyal G
Tilganga Institute of Ophthalmology, Kathmandu, Nepal.
Nepal J Ophthalmol. 2011 Jul-Dec;3(2):102-8. doi: 10.3126/nepjoph.v3i2.5260.
Endophthalmitis following cataract surgery is a rare but devastating ocular complication where delay in treatment not only results in vision loss but also in difficulty to save the eye ball.
To explore the clinical profile and visual outcome following pars plana vitrectomy (PPV) in acute endophthalmitis after cataract surgery.
This is a retrospective interventional case series study conducted at Tilganga Institute of Ophthalmology (TIO), Nepal. All consecutive cases of acute endophthalmitis following cataract surgery treated with PPV from January 2005 to August 2010 were included in the study.
There were a total of 34 cases (34 eyes) treated with PPV. The age range was 8 - 93 years with mean age of 56.9 ± 19.5 years. The mean duration of presentation and duration following cataract surgery was 7.7 ± 8.1 days and 13 ± 11.6 days respectively. Small incision cataract surgery was done in 75 % of cases followed by phacoemulsification (15.6 %). The mean duration of the last follow -up was 4.3 months. Vision was improved in two-thirds of cases (67.67 %) with a good vision of 6/18 or better in 17.6 %. Among the available vitreous samples of 22 cases, 36.36 % had an abnormality in Gram and Giemsa stains and culture was positive in 13.6 % of cases.
Despite the late presentation, the majority of eyes were salvaged with improvement of vision in 67.67 %, with a good vision of 6/18 or better in 17.6 4 % of cases following PPV in acute post operative endophthalmitis.
白内障手术后发生的眼内炎是一种罕见但极具破坏性的眼部并发症,治疗延迟不仅会导致视力丧失,还会增加眼球挽救的难度。
探讨白内障手术后急性眼内炎行玻璃体切割术(PPV)后的临床特征及视力预后。
这是一项在尼泊尔蒂尔冈加眼科研究所(TIO)进行的回顾性干预性病例系列研究。纳入2005年1月至2010年8月期间所有因白内障手术后急性眼内炎接受PPV治疗的连续病例。
共有34例(34只眼)接受了PPV治疗。年龄范围为8 - 93岁,平均年龄为56.9±19.5岁。出现症状的平均时长及白内障手术后的时长分别为7.7±8.1天和13±11.6天。75%的病例采用小切口白内障手术,15.6%的病例采用超声乳化白内障吸除术。最后一次随访的平均时长为4.3个月。三分之二的病例(67.67%)视力得到改善,17.6%的病例视力达到6/18或更好。在22例可获取玻璃体样本的病例中,36.36%的革兰氏染色和吉姆萨染色异常,13.6%的病例培养结果呈阳性。
尽管就诊较晚,但在急性术后眼内炎行PPV治疗后,大多数眼球得以挽救,67.67%的病例视力得到改善,17.6%的病例视力达到6/18或更好。