Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC.
Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC; National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC.
J Chin Med Assoc. 2017 Aug;80(8):503-507. doi: 10.1016/j.jcma.2017.05.001. Epub 2017 Jun 7.
To report our 3-year experience of 23-gauge transconjunctival sutureless vitrectomy (TSV) for acute postoperative endophthalmitis at a tertiary referral center in southern Taiwan.
This retrospective chart review study included 19 patients with acute postoperative endophthalmitis who underwent 23-gauge TSV from January 2011 to January 2015 at Kaohsiung Veterans General Hospital, Taiwan. Bacterial and fungal cultures from aqueous samples, vitreous samples, or both were performed.
Nineteen patients (12 male; 7 female) were included. The mean age was 72.4 ± 8.29 years. Acute postoperative endophthalmitis was noted in 18 patients after cataract surgery and in 1 patient after 23-gauge vitrectomy for a rhegmatogenous retinal detachment. Upon presentation, visual acuity was less than hand movement for 80% of the patients. Chief complaints included blurred vision (19 patients, 100%), followed by pain (10 patients, 52.6%) and red eye (4 patients, 21%). All patients were administered an intravitreal injection (IVI) of antibiotics and 23-gauge TSV, and the average number of IVIs was 2.68 ± 1.73 (1-9 IVIs). The interval between their initial eye symptoms and vitrectomy was 4.11 ± 4.73 days (0-2 days), and the interval between diagnosis with endophthalmitis and a vitrectomy was 1.11 ± 1.52 days (0-6 days). The final visual acuity was no light perception for 1 patient (5.3%), between 6/60 and 6/12 for 8 patients (42.1%), and 6/12 or better for 9 patients (47.4%). No retinal detachment or hypotony was noted postoperatively in any case.
23-gauge vitrectomy is safe and effective for the management of acute postoperative endophthalmitis. Early diagnosis and treatment with 23-gauge vitrectomy may provide a good visual outcome.
报告我们在台湾南部的一家三级转诊中心，3 年来对 23 号经结膜无缝线玻璃体切除术（23-gauge transconjunctival sutureless vitrectomy，TSV）治疗急性术后眼内炎的经验。
本回顾性图表研究纳入了 19 例于 2011 年 1 月至 2015 年 1 月期间在高雄荣民总医院接受 23 号 TSV 治疗的急性术后眼内炎患者。对房水样本、玻璃体样本或两者均进行了细菌和真菌培养。
19 例患者（男 12 例，女 7 例）纳入本研究。平均年龄为 72.4 ± 8.29 岁。18 例患者在白内障手术后发生急性术后眼内炎，1 例患者在 23 号 TSV 治疗孔源性视网膜脱离后发生急性术后眼内炎。就诊时，80%的患者视力低于手动视力。主要主诉包括视力模糊（19 例，100%），其次是疼痛（10 例，52.6%）和眼红（4 例，21%）。所有患者均接受了玻璃体腔内注射（intravitreal injection，IVI）抗生素和 23 号 TSV，IVI 的平均次数为 2.68 ± 1.73（1-9 次）。他们最初眼部症状和玻璃体切除之间的时间间隔为 4.11 ± 4.73 天（0-2 天），眼内炎诊断和玻璃体切除之间的时间间隔为 1.11 ± 1.52 天（0-6 天）。最终视力无光感 1 例（5.3%），6/60-6/12 8 例（42.1%），6/12 或更好 9 例（47.4%）。任何情况下术后均未发生视网膜脱离或低眼压。
23 号 TSV 治疗急性术后眼内炎安全有效。早期诊断和治疗，联合使用 23 号 TSV，可能会获得良好的视力预后。
