From St. Erik Eye Hospital (Friling, Montan), Stockholm, the Department of Clinical Sciences, Ophthalmology (Lundström), Faculty of Medicine, Lund University, Lund, and Sahlgrenska University Hospital (Stenevi), Molndal, Sweden.
From St. Erik Eye Hospital (Friling, Montan), Stockholm, the Department of Clinical Sciences, Ophthalmology (Lundström), Faculty of Medicine, Lund University, Lund, and Sahlgrenska University Hospital (Stenevi), Molndal, Sweden.
J Cataract Refract Surg. 2013 Jan;39(1):15-21. doi: 10.1016/j.jcrs.2012.10.037.
To report the nationwide incidence and risk factors for endophthalmitis after cataract surgery in Sweden.
Swedish National Cataract Register containing reports on cataract operations from all Swedish ophthalmic surgical units.
Prospective epidemiologic study.
Endophthalmitis case reports were collected from 2005 through 2010. Case and control parameters pertaining to patient characteristics and surgical technique were generated from the database. In addition, information from annual surveys regarding the topical prophylactic protocol was analyzed.
The reports showed 135 endophthalmitis cases in 464,996 operations, equaling an incidence of 0.029%. Patient age over 85 years, perioperative communication with the vitreous and, above all, nonuse of intracameral cefuroxime showed a statistically significant association with endophthalmitis in the logistic regression. Short-term topical antibiotics given as add-on prophylaxis to the intracameral regimen before, after, or before and after the operation did not confer a clear-cut benefit. Groups with topical treatment were small, comprising 14% of the sample.
The incidence of endophthalmitis after cataract surgery in Sweden is declining, which appears to be explained by a fall in the frequency of major risk factors. Operating earlier in the cataract course, avoiding capsule breakage, and giving intracameral antibiotics universally should further reduce the endophthalmitis rate.
报告在瑞典白内障手术后眼内炎的全国发病率和危险因素。
瑞典国家白内障登记处包含了来自所有瑞典眼科手术单位的白内障手术报告。
前瞻性流行病学研究。
从 2005 年至 2010 年收集眼内炎病例报告。从数据库中生成与患者特征和手术技术相关的病例和对照参数。此外，还分析了关于局部预防方案的年度调查信息。
报告显示在 464996 例手术中发生了 135 例眼内炎，发病率为 0.029%。患者年龄超过 85 岁、手术期间与玻璃体接触以及最重要的是未使用玻璃体内头孢呋辛与眼内炎在逻辑回归中有统计学显著关联。短期局部抗生素作为眼内抗生素方案的附加预防措施，在手术前、后或前后使用，并没有明显的益处。局部治疗组规模较小，占样本的 14%。
瑞典白内障手术后眼内炎的发病率正在下降，这似乎可以解释为主要危险因素的频率下降。在白内障病程早期进行手术、避免囊袋破裂以及普遍使用玻璃体内抗生素应该进一步降低眼内炎的发生率。
