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尼泊尔一家三级眼科护理中心行玻璃体切割术后外伤性眼内炎的临床微生物学特征及视力预后

Clinico-microbiological Profile and Visual outcome in Traumatic Endophthalmitis following Pars Plana Vitrectomy at a Tertiary Eye Care Centre of Nepal.

作者信息

Thapa R, Paudyal G

机构信息

Tilganga Institute of Ophthalmology, Gaushala, Kathmandu, Nepal.

出版信息

JNMA J Nepal Med Assoc. 2014 Jul-Sep;52(195):886-91.

Abstract

INTRODUCTION

Endophthalmitis is a potentially devastating ocular complication of perforating eye injury (PEI) where prompt intervention can save some vision. This study aims to explore the clinico-microbiologic profile and visual outcome following pars plana vitrectomy (PPV) in traumatic endophthalmitis.

METHODS

This is a retrospective interventional case series study conducted at a tertiary eye care centre of Nepal. A total of 49 consecutive cases (49 eyes) of endophthalmitis following PEI, who underwent PPV from January 2007 to June 2010 were included in the study.

RESULTS

Mean age was 14.7 years (S.D. 14.27). Twenty seven patients (55%) were of age group below 10 years. Male to female ratio was 2.75:1. Mean duration of presentation was 8.9 days. Nineteen eyes (36.73%) had injuries with wooden sticks, followed by injury with metallic objects in 16 patients (32.56%). PEI involving zone I was found in 31 eyes (63.25%). The retained intraocular foreign body was found in seven patients (14.2%). The post operative vision improved in almost 24 cases (49%) with visual recovery of 20/200 and better in six cases (12.24%). The vitreous culture was positive in five cases (12.8%) with predominant streptococcus pneumonia in four cases (10.25%).

CONCLUSIONS

Children were the mostly affected group with males outnumbering females. Wooden sticks and metallic objects were the commonest insulting agents. Despite the late presentation and predominant zone I injury, eye could be salvaged in majority with visual recovery of 20/200 and better in six cases (12.24%).

摘要

引言

眼内炎是眼球穿孔伤(PEI)潜在的严重眼部并发症,及时干预可挽救部分视力。本研究旨在探讨外伤性眼内炎行玻璃体切割术(PPV)后的临床微生物学特征及视力预后。

方法

这是一项在尼泊尔一家三级眼科护理中心进行的回顾性干预性病例系列研究。纳入了2007年1月至2010年6月期间因PEI后发生眼内炎而接受PPV的49例连续病例(49只眼)。

结果

平均年龄为14.7岁(标准差14.27)。27例患者(55%)年龄在10岁以下。男女比例为2.75:1。平均就诊时间为8.9天。19只眼(36.73%)因木棍受伤,其次是16例患者(32.56%)因金属物体受伤。31只眼(63.25%)的PEI累及I区。7例患者(14.2%)发现有眼内异物残留。术后近24例(49%)视力改善,6例(12.24%)视力恢复到20/200及以上。玻璃体培养5例(12.8%)呈阳性,其中4例(10.25%)以肺炎链球菌为主。

结论

儿童是受影响最严重的群体,男性多于女性。木棍和金属物体是最常见的致伤物。尽管就诊较晚且I区损伤占主导,但大多数患者的眼睛仍可挽救,6例(12.24%)视力恢复到20/200及以上。

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