Mutoh Tetsuya, Kadoya Koji, Chikuda Makoto
Department of Ophthalmology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan.
Clin Ophthalmol. 2012;6:1393-7. doi: 10.2147/OPTH.S35123. Epub 2012 Aug 28.
We report our recent experience with four cases of endophthalmitis (one male, three females) after 25-gauge pars plana vitrectomy (PPV). One was a case of persistent cystoid macular edema caused by branch retinal vein occlusion, whereas the remaining three were cases of epiretinal membrane. Preoperative antibiotics before the first PPV procedure were not administered in three of the four cases. Endophthalmitis occurred 2-4 days after the first procedure in all cases, for which ceftazidime 2.0 mg/0.1 mL and vancomycin 1.0 mg/0.1 mL were injected into the vitreous cavity. This was followed by emergent 20-gauge PPV and intraocular lens removal using an infusion fluid containing ceftazidime and vancomycin. After the second PPV procedure, progress was good in three cases while retinal detachment occurred in the remaining case one month after surgery; this case required a third PPV procedure. Final best-corrected visual acuity ranged from 20/100 to 20/25 for the four cases. Bacterial cultures were negative after the second PPV procedure in all cases. In conclusion, postoperative endophthalmitis occurred in four of 502 cases (0.80%) that underwent 25-gauge PPV at our hospital. It is important to minimize the incidence of endophthalmitis after 25-gauge PPV.
我们报告了近期在25G玻璃体切割术（PPV）后发生的4例眼内炎病例（1例男性，3例女性）的经验。其中1例是由视网膜分支静脉阻塞引起的持续性黄斑囊样水肿，其余3例为视网膜前膜。4例中有3例在首次PPV手术前未使用术前抗生素。所有病例的眼内炎均发生在首次手术后2 - 4天，向玻璃体腔注射头孢他啶2.0 mg/0.1 mL和万古霉素1.0 mg/0.1 mL。随后紧急进行20G PPV，并使用含头孢他啶和万古霉素的灌注液取出人工晶状体。第二次PPV手术后，3例病情好转，其余1例在术后1个月发生视网膜脱离，该病例需要进行第三次PPV手术。4例患者最终的最佳矫正视力范围为20/100至20/25。所有病例在第二次PPV手术后细菌培养均为阴性。总之，在我院接受25G PPV的502例患者中，有4例（0.80%）发生了术后眼内炎。将25G PPV术后眼内炎的发生率降至最低很重要。
