Duker J S, Belmont J B
Retina Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA 19107.
Retina. 1989;9(4):263-6. doi: 10.1097/00006982-198909040-00004.
We report two cases of late postoperative bacterial endophthalmitis that occurred following retinal detachment repair. Both patients presented months after their scleral buckling procedures with a subacute uveitis. Over a period of one to two weeks, the inflammation gradually increased, until the classic clinical appearance of fulminant bacterial endophthalmitis was present. In an effort to treat the infection, a pars plana vitrectomy was performed in both cases. At the time of vitreous surgery, intrusion of the scleral buckling elements into the globe was observed, suggesting a possible means of entry for the infectious agent. Removal of the buckling elements, repair of the scleral defects, and injection of intravitreal antibiotics were performed as therapeutic interventions. Vitreous cultures were positive in both cases for Proteus mirabilis. Postoperatively the retina remained attached in both instances, and, in one case, the visual acuity returned to 20/20.
我们报告了两例视网膜脱离修复术后发生的迟发性细菌性眼内炎病例。两名患者在巩膜扣带手术后数月出现亚急性葡萄膜炎。在一到两周的时间里，炎症逐渐加重，直至出现暴发性细菌性眼内炎的典型临床表现。为治疗感染，两例患者均进行了玻璃体切除术。在玻璃体手术时，观察到巩膜扣带元件侵入眼球，提示这可能是感染病原体的一种进入途径。作为治疗干预措施，移除了扣带元件，修复了巩膜缺损，并注射了玻璃体腔内抗生素。两例患者的玻璃体培养均显示奇异变形杆菌阳性。术后，两例患者的视网膜均保持附着，其中一例患者的视力恢复到了20/20。
