State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, and Department of Ophthalmology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Ophthalmologica. 2011;226(4):214-9. doi: 10.1159/000330980. Epub 2011 Sep 2.
Posttraumatic endophthalmitis (PTE) managed with pars plana vitrectomy (PPV) and a variety of other methods often resulted in retinal detachment (RD), which deteriorates postoperative visual acuity (VA). We investigated initial ocular conditions, surgical management and outcomes of PTE patients and analyzed their relationship in order to find the necessary management for different patients' conditions.
Retrospective study. Medical records of 62 consecutive patients who were diagnosed with PTE and managed with PPV were retrospectively analyzed. The included patients were divided into two groups depending on their initial VA, with light perception (LP) as borderline: group A (12 cases; VA=LP) and group B (50 cases; VA>LP). Specific variables related to surgical outcomes were analyzed, including: initial VA; intraocular foreign body; location and length of the wound; microbiologic test; cataract extraction; scleral buckling; silicon oil tamponade; gas tamponade, and retinal restoration. Data were statistically analyzed by the χ2 test, by univariate analysis for predictors and by multivariate logistic regression analysis.
RD happened in 19 (30.6%) of the 62 cases included. There were 6 cases (50%) in group A and 13 cases (26%) in group B which resulted in RD. Statistical analysis demonstrated that none of the related factors were correlated to the occurrence of RD (all factors: p>0.05) in group A, but in group B, scleral buckling (with: 2/22, 9%; without: 11/28, 39%; p<0.05) and silicone oil tamponade (with: 0/6; without: 13/44, 30%; p<0.05) were statistically significantly correlated to the occurrence of RD.
Preventive scleral buckling and silicone oil tamponade are important for patients with good initial VA (VA>LP) to be successfully managed by PPV.
经玻璃体切除术（PPV）和多种其他方法治疗的创伤后眼内炎（PTE）常导致视网膜脱离（RD），从而使术后视力（VA）恶化。我们研究了 PTE 患者的初始眼部状况、手术治疗和结果，并对其进行了分析，以找到针对不同患者病情的必要治疗方法。
回顾性研究。回顾性分析了 62 例连续诊断为 PTE 并接受 PPV 治疗的患者的病历。根据初始 VA 将纳入患者分为两组，以光感（LP）为边界：A 组（12 例；VA=LP）和 B 组（50 例；VA>LP）。分析了与手术结果相关的特定变量，包括：初始 VA；眼内异物；伤口位置和长度；微生物学检查；白内障摘除；巩膜扣带术；硅油填充；气体填充和视网膜复位。采用 χ2 检验、单因素分析预测因子和多因素逻辑回归分析对数据进行统计学分析。
62 例患者中有 19 例（30.6%）发生 RD。A 组中有 6 例（50%），B 组中有 13 例（26%）发生 RD。统计分析表明，A 组中没有任何相关因素与 RD 的发生相关（所有因素：p>0.05），但在 B 组中，巩膜扣带术（有：2/22，9%；无：11/28，39%；p<0.05）和硅油填充（有：0/6；无：13/44，30%；p<0.05）与 RD 的发生有统计学显著相关性。
对于初始 VA（VA>LP）良好的患者，预防性巩膜扣带术和硅油填充术对于成功接受 PPV 治疗至关重要。
