Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing 100730, China.
Chin Med J (Engl). 2013;126(15):2890-3.
Endophthalmitis can be a devastating complication after pars plana vitrectomy. The incidence of postvitrectomy endophthalmitis is significantly lower than that of endophthalmitis occurring after other intraocular operations. However, normal post-operative pain and inflammation may mask endophthalmitis and lead to delayed diagnosis and grave visual consequences. This study aimed to summarize the outcomes of cases that underwent pars plana vitrectomy over a 10-year period and to analyze the characteristics of post-vitrectomy endophthalmitis.
A retrospective observational case study was conducted on all the cases who underwent pars plana vitrectomy in the Beijing Tongren Hospital between January 1, 2002 and March 31, 2012. All cases of endophthalmitis that occurred during a period of 10 years and 3 months were reviewed, and the possible risk factors, clinical findings, causative organism(s), and the sources of infection were analyzed.
Within the 10-year observational period, 14 patients developed endophthalmitis after pars plana vitrectomy. The incidence of post-vitrectomy endophthalmitis (0.05%) was lower than that reported previously from the same center (0.12%). Staphylococcus epidermidis (five patients, 35.71%) was the most common organism identified in aqueous or vitreous cultures. Eight patients (57.14%) had diabetes mellitus. There was no statistically significant difference (P > 0.05) in the incidence of endophthalmitis between period 1 (with antibiotic pretreatment) and period 2 (without antibiotic pretreatment). Surgical procedures for the treatment of endophthalmitis were performed in 10 patients (71.43%).
This series of cases showed that the incidence of endophthalmitis after pars plana vitrectomy is lower than what was previously reported in our hospital. A variable degree of corneal edema with relatively normal or mildly increased intraocular pressure was one of the commonly observed characteristics of post-vitrectomy endophthalmitis. Staph. epidermidis was the most common causative organism, and antibiotic pretreatment did not lower the incidence of postvitrectomy endophthalmitis.
眼内炎是玻璃体切割术后一种严重的并发症。与其他眼内手术后发生的眼内炎相比，玻璃体切割术后眼内炎的发生率明显较低。然而，术后正常的疼痛和炎症可能会掩盖眼内炎，导致诊断延迟和严重的视力后果。本研究旨在总结 10 年间行玻璃体切割术的病例结果，并分析玻璃体切割术后眼内炎的特征。
对 2002 年 1 月 1 日至 2012 年 3 月 31 日期间在北京同仁医院行玻璃体切割术的所有病例进行回顾性观察性病例研究。回顾分析 10 年 3 个月期间发生的所有眼内炎病例，分析可能的危险因素、临床发现、病原体和感染源。
在 10 年观察期间，14 例患者在行玻璃体切割术后发生眼内炎。玻璃体切割术后眼内炎的发生率（0.05%）低于同一中心此前报道的发生率（0.12%）。在房水或玻璃体培养中，表皮葡萄球菌（5 例，35.71%）是最常见的病原体。8 例（57.14%）患者患有糖尿病。第 1 期（有抗生素预处理）和第 2 期（无抗生素预处理）之间眼内炎的发生率无统计学差异（P>0.05）。10 例（71.43%）患者接受了眼内炎治疗手术。
本系列病例表明，玻璃体切割术后眼内炎的发生率低于我院此前的报道。相对正常或轻度升高的眼压下存在不同程度的角膜水肿是玻璃体切割术后眼内炎的常见特征之一。表皮葡萄球菌是最常见的病原体，抗生素预处理并不能降低玻璃体切割术后眼内炎的发生率。
