巩膜扣带术联合吊灯式眼内照明术后急性细菌性眼内炎
Acute bacterial endophthalmitis after scleral buckling surgery with chandelier endoillumination.
作者信息
Sakono Takato, Otsuka Hiroki, Shiihara Hideki, Yoshihara Naoya, Sakamoto Taiji
机构信息
Department of Ophthalmology Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
出版信息
Am J Ophthalmol Case Rep. 2017 Jul 21;8:7-10. doi: 10.1016/j.ajoc.2017.07.007. eCollection 2017 Dec.
PURPOSE
The non-contact wide-angle viewing system (WAVS) with chandelier endoillumination is being used more commonly during scleral buckling surgery for rhegmatogenous retinal detachments although its safety has not been established. We report our findings in a case of bacterial endophthalmitis that developed after scleral buckling surgery with WAVS and chandelier endoillumination.
OBSERVATIONS
A 42-year-old man underwent scleral buckling surgery for a rhegmatogenous retinal detachment in his right eye using a WAVS with chandelier endoillumination. Three days after the surgery, the patient noticed a marked decrease in his vision with ocular pain. Slit-lamp examination showed dense infiltration in the anterior chamber and vitreous body. Pars plana vitrectomy with antibiotic irrigation was done immediately, and was detected in the vitreous fluid. After vancomycin 6/day for 4 weeks, the inflammation gradually subsided, and the visual acuity recovered to 20/20 in 3 months.
CONCLUSIONS AND IMPORTANCE
Acute bacterial endophthalmitis can develop after scleral buckling surgery performed with WAVS and chandelier endoillumination.
目的
尽管非接触式广角观察系统（WAVS）联合吊灯式眼内照明的安全性尚未确定，但在孔源性视网膜脱离的巩膜扣带手术中使用得越来越普遍。我们报告了1例在使用WAVS联合吊灯式眼内照明进行巩膜扣带手术后发生细菌性眼内炎的病例及相关发现。
观察结果
一名42岁男性因右眼孔源性视网膜脱离接受了使用WAVS联合吊灯式眼内照明的巩膜扣带手术。术后3天，患者出现视力显著下降并伴有眼痛。裂隙灯检查显示前房和玻璃体有致密浸润。立即进行了玻璃体切割术并使用抗生素冲洗，在玻璃体液中检测到了（此处原文缺失相关内容）。给予万古霉素每日6次，持续4周后，炎症逐渐消退，3个月时视力恢复到20/20。
结论与意义
使用WAVS联合吊灯式眼内照明进行巩膜扣带手术后可能发生急性细菌性眼内炎。
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