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眼内炎的内镜下玻璃体切除术:一家三级眼科护理中心33例患者的初步经验

Endoscopic vitrectomy in endophthalmitis: initial experience of 33 cases at a tertiary eye care center.

作者信息

Dave Vivek Pravin, Pappuru Rajeev R, Tyagi Mudit, Pathengay Avinash, Das Taraprasad

机构信息

Smt Kanuri Santhamma Center for Vitreoretinal Diseases, Kallam Anji Reddy Campus, LV Prasad Eye Institute, Hyderabad 500034, Telangana, India,

Retina and Uveitis Department, GMR Varalaxmi Campus, LV Prasad Eye Institute, Hanumanthawaka Chowk, Visakhapatnam 530040, Andhra Pradesh, India.

出版信息

Clin Ophthalmol. 2019 Feb 5;13:243-251. doi: 10.2147/OPTH.S185716. eCollection 2019.

Abstract

PURPOSE

To report the presentation and management outcomes of endophthalmitis with endoscopic vitrectomy.

METHODS

This is a retrospective interventional case series conducted at a tertiary eye care center in south India. Thirty three eyes of 33 patients were included. The medical records of the patients who underwent endoscopic vitrectomy for endophthalmitis from April 2014 to March 2018 were reviewed. Data with regard to age, gender, etiology of endophthalmitis, corneal and retinal examination, type of intervention, final anatomic and visual outcome, and the total follow-up were collected. The main outcome measures were the final visual acuity and evisceration rates.

RESULTS

The mean age at presentation was 46.84±19.89 years, with a median age of 50 years. Based on etiology, 13 eyes (39.4%) were post-trauma endophthalmitis, eleven eyes (33.33%) were post-cataract surgery, three eyes (9.09%) were endogenous, three eyes (9.09%) were post-perforated corneal ulcer, two eyes (6.06%) were post-retinal surgery, and one eye (3.03%) was post-combined cataract and corneal surgery. Twenty-four eyes (72.72%) had a favorable anatomic outcome at the last visit, and five eyes (15.15%) had a favorable visual outcome. Of those with unfavorable visual outcome, ten eyes had further visual potential. Sixteen eyes (48.48%) showed a positive culture on microbiologic evaluation. The predominant organism isolated was . Evisceration was required only in one eye (3.03%).

CONCLUSION

Endoscopic vitrectomy allows early management of endophthalmitis in spite of hazy media. This ensures a reasonable visual outcome, controls the infection, and reduces the incidence of evisceration in these eyes.

摘要

目的

报告采用内镜玻璃体切除术治疗眼内炎的临床表现及治疗效果。

方法

这是一项在印度南部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33例患者的33只眼。回顾了2014年4月至2018年3月期间因眼内炎接受内镜玻璃体切除术的患者的病历。收集了有关年龄、性别、眼内炎病因、角膜和视网膜检查、干预类型、最终解剖和视觉结果以及总随访情况的数据。主要结局指标为最终视力和眼球摘除率。

结果

就诊时的平均年龄为46.84±19.89岁,中位年龄为50岁。根据病因,13只眼(39.4%)为外伤后眼内炎,11只眼(33.33%)为白内障手术后,3只眼(9.09%)为内源性,3只眼(9.09%)为角膜穿孔溃疡后,2只眼(6.06%)为视网膜手术后,1只眼(3.03%)为白内障和角膜联合手术后。24只眼(72.72%)在最后一次随访时解剖结果良好,5只眼(15.15%)视觉结果良好。在视觉结果不佳的患者中,10只眼有进一步的视觉潜力。16只眼(48.48%)微生物学评估培养结果为阳性。分离出的主要病原体为……仅1只眼(3.03%)需要进行眼球摘除。

结论

尽管介质模糊,内镜玻璃体切除术仍可对眼内炎进行早期治疗。这可确保获得合理的视觉结果,控制感染,并降低这些眼的眼球摘除率。

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