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创伤后眼内炎:一项为期18年的病例系列研究。

POSTTRAUMATIC ENDOPHTHALMITIS: An 18-Year Case Series.

作者信息

Li Xintong, Zarbin Marco A, Langer Paul D, Bhagat Neelakshi

机构信息

Department of Ophthalmology, Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey.

出版信息

Retina. 2018 Jan;38(1):60-71. doi: 10.1097/IAE.0000000000001511.

Abstract

PURPOSE

To describe the demographics, characteristics, management, and visual outcomes of eyes diagnosed with endophthalmitis after open globe injury.

METHODS

Retrospective cohort analysis of all patients diagnosed with endophthalmitis after open globe injury from 1997 to 2015 at University Hospital, Newark, NJ.

RESULTS

Twenty-six eyes were identified (all male patients; mean age: 37 ± 15 years). Cultures were positive in 16 eyes (62%), with Staphylococcus species (7 eyes, 44%) being the most common organism. Twelve eyes (46%) presented with open globe injury and concurrent endophthalmitis; 14 eyes (54%) developed endophthalmitis a mean of 14 days after open globe repair (OGR; 1 outlier of 98 days excluded). All eyes were managed with systemic and intravitreal antibiotics. The presence of intraocular foreign body (P < 0.05) and delayed primary OGR (P < 0.03) were significantly more common with concurrent versus post-OGR endophthalmitis. Four (29%) eyes in the post-OGR endophthalmitis group had corneal wound leak after OGR. Four (15%) eyes with no light perception vision were enucleated. Ten (40%) of 25 eyes with documented best-corrected visual acuity had final best-corrected visual acuity ≥20/200; final best-corrected visual acuity ranged from no light perception to 20/20.

CONCLUSION

The presence of intraocular foreign body and delayed presentation were significantly more common with concurrent endophthalmitis. Twenty-nine percent of eyes that presented with endophthalmitis after OGR had a wound leak. Final best-corrected visual acuity ≥20/200 was achieved in 40% of cases.

摘要

目的

描述开放性眼球损伤后诊断为眼内炎的患者的人口统计学特征、临床表现、治疗方法及视力预后。

方法

对1997年至2015年在新泽西州纽瓦克大学医院诊断为开放性眼球损伤后眼内炎的所有患者进行回顾性队列分析。

结果

共纳入26只眼(所有患者均为男性;平均年龄:37±15岁)。16只眼(62%)培养结果呈阳性,其中葡萄球菌属(7只眼,44%)为最常见病原体。12只眼(46%)为开放性眼球损伤并发眼内炎;14只眼(54%)在开放性眼球修复术后平均14天发生眼内炎(排除1例98天的异常值)。所有患眼均接受全身及玻璃体腔内抗生素治疗。与开放性眼球修复术后眼内炎相比,并发眼内炎时眼内异物的存在(P<0.05)和延迟一期开放性眼球修复术(P<0.03)更为常见。开放性眼球修复术后眼内炎组有4只眼(29%)在开放性眼球修复术后发生角膜伤口渗漏。4只眼(15%)无光感,行眼球摘除术。在记录了最佳矫正视力的25只眼中,10只眼(40%)最终最佳矫正视力≥20/200;最终最佳矫正视力范围从无光感到20/20。

结论

并发眼内炎时眼内异物的存在及延迟就诊更为常见。开放性眼球修复术后发生眼内炎的患眼中,29%存在伤口渗漏。40%的病例最终最佳矫正视力≥20/200。

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