Do Tan, Hon Do N, Aung Tin, Hien Nguyen Dtn, Cowan Claude L
Vietnam National Institute of Ophthalmology, Hanoi, Vietnam.
Singapore National Eye Center, Singapore.
Clin Ophthalmol. 2014 Aug 28;8:1633-40. doi: 10.2147/OPTH.S67589. eCollection 2014.
BACKGROUND/AIMS: To compare treatment outcomes with and without silicone oil tamponade in patients undergoing pars plana vitrectomy (PPV) for severe endogenous bacterial endophthalmitis (BEE).
One hundred and eight consecutive patients with severe BEE (defined by the absence of pupil red reflex at presentation and/or dense vitreous opacity on ultrasound and no improvement after 24-36 hours of medical treatment) were randomly assigned to two treatment groups: Group 1, standard PPV with intravitreal antibiotics; and Group 2, PPV with intravitreal antibiotics and silicone tamponade. Overall success was defined as: a visual acuity ≥ count fingers at 1 meter, with an attached retina, and no intraocular oil.
Fifty three patients were randomized to Group 1 and 55 patients to Group 2. The mean age of study subjects was 32 years and baseline clinical characteristics were similar in both groups. At the final follow-up visit at 9 months, the overall success rate of Group 2 (67.3%) was significantly better than Group 1 (43.4%; P=0.01). There were also fewer devastating complications (such as inoperable retinal detachment, phthisis bulbi) in Group 2 compared with Group 1 (21.8% versus 43.4%; P=0.01).
The outcome at 9 months of patients with BEE treated by vitrectomy with silicone oil was better than those treated by vitrectomy alone.
背景/目的：比较在接受玻璃体切割术（PPV）治疗严重内源性细菌性眼内炎（BEE）的患者中，使用硅油填塞与不使用硅油填塞的治疗效果。
连续纳入108例严重BEE患者（定义为就诊时无瞳孔红光反射和/或超声显示玻璃体致密混浊，且药物治疗24 - 36小时后无改善），随机分为两个治疗组：第1组，标准PPV联合玻璃体内注射抗生素；第2组，PPV联合玻璃体内注射抗生素及硅油填塞。总体成功定义为：视力≥1米处数指，视网膜附着，且眼内无硅油。
53例患者随机分配至第1组，55例患者随机分配至第2组。研究对象的平均年龄为32岁，两组的基线临床特征相似。在9个月的最终随访时，第2组的总体成功率（67.3%）显著高于第1组（43.4%；P = 0.01）。与第1组相比，第2组的严重并发症（如无法手术的视网膜脱离、眼球痨）也更少（21.8%对43.4%；P = 0.01）。
硅油玻璃体切割术治疗BEE患者9个月时的效果优于单纯玻璃体切割术。
