Xiao Bo, Yang Jin, Chu Yanhua, Han Quanhong
Department of Vitreous and Retina, Tianjin Eye Hospital, Tianjin Eye Institute, Tianjin Key Lab of Ophthalmology and Visual Science, Clinical College of Ophthalmology, Tianjin Medical University, 4#, Gansu Road, Heping District, Tianjin, 300020, China.
Tianjin Medical University Eye Hospital, Tianjin, China.
Int Ophthalmol. 2018 Dec;38(6):2663-2668. doi: 10.1007/s10792-017-0747-4. Epub 2017 Oct 23.
To summarize the characters of 6 bleb-associated endophthalmitis (BAE) cases and to report the outcomes of prompt 27-gauge sutureless transconjunctival vitrectomy to treat these cases.
Retrospective, non-randomized, consecutive case series of patients diagnosed with bleb-associated endophthalmitis who underwent prompt 27-gauge vitrectomy.
The interval to get bleb-associated endophthalmitis from previous surgery was variant from 2 weeks to 36 months. Most of the patients experienced eye pain. The visual acuity was affected quickly. All the patients presented with hypopyon, fibrinous reaction, and vitreous wick. The size of the hypopyon was from 2 to 4 mm. Two patients came with intraocular lenses. Prompt 27-gauge sutureless transconjunctival vitrectomy was performed on all patients with bleb-associated endophthalmitis. None of the patients experienced complications of sutureless vitrectomy such as hypotony or wound leak. The improvement of best corrected visual acuity (BCVA) was significant in four of six patients. The improvement of BCVA was statistically calculated by using logMAR VA (p < 0.01). The intraocular pressure (IOP) in all six patients reduced after the surgery. At 6 months' follow-up, four patients with diffuse blebs had normal IOPs while two patients with cystic or encapsulated blebs had uncontrolled IOPs (> 21 mmHg) and received pressure-lowering agents.
BAE is associated with substantial visual morbidity. Prompt 27-gauge sutureless transconjunctival vitrectomy is an effective and safe way for treating bleb-associated endophthalmitis.
总结6例与滤过泡相关的眼内炎（BAE）病例的特征，并报告采用27G无缝线经结膜玻璃体切除术迅速治疗这些病例的结果。
对诊断为与滤过泡相关的眼内炎并接受27G玻璃体切除术的患者进行回顾性、非随机、连续病例系列研究。
从上一次手术到发生与滤过泡相关的眼内炎的间隔时间从2周至36个月不等。大多数患者有眼痛症状。视力迅速受到影响。所有患者均出现前房积脓、纤维蛋白反应和玻璃体条索。前房积脓大小为2至4毫米。两名患者植入了人工晶状体。所有与滤过泡相关的眼内炎患者均接受了27G无缝线经结膜玻璃体切除术。所有患者均未出现无缝线玻璃体切除术的并发症，如低眼压或伤口渗漏。6例患者中有4例最佳矫正视力（BCVA）有显著改善。采用logMAR视力表对BCVA的改善进行统计学计算（p<0.01）。所有6例患者术后眼压均降低。随访6个月时，4例弥漫性滤过泡患者眼压正常，而2例囊性或包裹性滤过泡患者眼压未得到控制（>21mmHg），需使用降眼压药物。
BAE会导致严重的视力损害。迅速进行27G无缝线经结膜玻璃体切除术是治疗与滤过泡相关的眼内炎的一种有效且安全的方法。
