Höhn Fabian, Kretz Florian Ta, Sheth Saumil, Natarajan S, Singh Pankaj, Koch Frank H, Koss Michael J
Helios Klinikum Pforzheim, Pforzheim, Germany.
Department of Ophthalmology, Hospital of the Ruprecht-Karls University, Heidelberg, Germany.
Clin Ophthalmol. 2015 Aug 13;9:1457-61. doi: 10.2147/OPTH.S81262. eCollection 2015.
To evaluate the safety and effectiveness of the Intrector(®) for treating postoperative endophthalmitis.
In a retrospective multicenter study, patients who received a single port 23-gauge core pars plana vitrectomy and isovolumetric injection of vancomycin, ceftazidime, and dexamethasone/amphotericin B using the Intrector(®) for postoperative endophthalmitis of intermediate severity (grade II or III vitreous inflammation and best-corrected visual acuity between hand movements and 0.3 logMAR [logarithm of the minimum angle of resolution]) were evaluated. Improvement in visual acuity, resolution of intraocular inflammation, the need for additional surgical procedures, and the development of complications were evaluated at a 1-month follow-up examination.
Fifteen patients (mean age 55.6±7.2 years) underwent treatment with the Intrector(®). The mean vitreous volume aspirated was 0.78±0.22 mL. The vitreous samples indicated positive microorganism culture results in six of the 15 cases, but the samples were positive when analyzed by real-time polymerase chain reaction in all cases (15/15). The mean best-corrected visual acuity improved significantly (P=0.01) from 0.88±0.29 (logMAR) to 0.32±0.28. Each patient demonstrated at least three lines of visual improvement. No additional medical or surgical interventions were required, and the complete resolution of intraocular inflammation was noted in all patients at the 1-month follow-up examination. No procedure-related complications were observed.
The Intrector(®) may be a safe and effective treatment option for infectious postoperative endophthalmitis. Larger studies comparing the outcomes of the Intrector(®) to the traditional treatments for postoperative endophthalmitis need to be conducted before its role in the treatment of postoperative endophthalmitis can be properly defined.
评估Intrector(®)治疗术后眼内炎的安全性和有效性。
在一项回顾性多中心研究中，对接受单通道23G经平坦部玻璃体切除术并使用Intrector(®)等容注射万古霉素、头孢他啶和地塞米松/两性霉素B治疗中度严重程度（II级或III级玻璃体炎症，最佳矫正视力在手动和0.3 logMAR[最小分辨角对数]之间）术后眼内炎的患者进行了评估。在1个月的随访检查中评估视力改善情况、眼内炎症消退情况、是否需要额外的手术操作以及并发症的发生情况。
15例患者（平均年龄55.6±7.2岁）接受了Intrector(®)治疗。吸出的玻璃体平均体积为0.78±0.22 mL。玻璃体样本显示15例中有6例微生物培养结果为阳性，但所有病例经实时聚合酶链反应分析时样本均为阳性（15/15）。最佳矫正视力平均从0.88±0.29（logMAR）显著提高至0.32±0.28（P = 0.01）。每位患者的视力至少提高了三行。无需额外的药物或手术干预，在1个月的随访检查中所有患者的眼内炎症均完全消退。未观察到与手术相关的并发症。
Intrector(®)可能是感染性术后眼内炎的一种安全有效的治疗选择。在其在术后眼内炎治疗中的作用能够得到恰当定义之前，需要开展更大规模的研究，将Intrector(®)的治疗效果与术后眼内炎的传统治疗方法进行比较。
