Dave Vivek Pravin, Parmeshwarappa Deepika C, Dogra Avantika, Pappuru Rajeev Reddy, Pathengay Avinash, Joseph Joveeta, Das Taraprasad
Smt. Kanuri Santhamma Center for Vitreoretinal Diseases, Kallam Anji Reddy Campus, LV Prasad Eye Institute, Hyderabad, India.
Retina and Uveitis Service, GMR Varalakshmi Campus, LV Prasad Eye Institute, Visakhapatnam, India.
Clin Ophthalmol. 2020 Feb 26;14:551-555. doi: 10.2147/OPTH.S243496. eCollection 2020.
To compare the outcomes of delayed-onset low-grade endophthalmitis managed with and without intraocular lens (IOL) explantation.
Tertiary eye-care research institute in southern India.
Retrospective comparative case series.
The study included all cases of post-cataract surgery delayed-onset endophthalmitis from January 1990 to January 2019. Time to endophthalmitis, duration of symptoms, presenting visual acuity, time to IOL explantation when performed, resolution after explantation, number of intravitreal injections, and final visual acuity were compared in the IOL non-explanted and IOL explanted groups.
There were 115 eyes - 61 eyes in the IOL non-explant and 54 eyes in the IOL explant group. Between the two groups there was no statistically significant difference in age (58.37 ± 14.05 and 56.04 ± 14.96 years, respectively; p=0.35), vision at presentation (>20/400 in 29.5% and 29.6% eyes, respectively; p=0.98), and the duration of follow-up (14.38 ± 16.05, median 8.5 months and 7.06 ± 3.55, median 6 months respectively; p=0.43). There was a statistically significant difference between the IOL non-explant and IOL-explant groups in the time to resolution of inflammation (92.70 ± 36.28 and 45.33±11.2 days, respectively; p <0.0001) and the number of intravitreal injections (4.57 ± 0.75, median 5 and 2.79±2.11, median 2 respectively, p=0.005). Persistent/recurrent inflammation at 6 months was recorded in 18.03% and 5.55% in the IOL non-explant and IOL explant eyes, respectively (p=0.04). Favorable functional outcome was seen in 50.81% vs 68.51% in IOL non-explant and explant eyes, respectively (p=0.05).
IOL explantation in delayed-onset endophthalmitis helps in earlier resolution of inflammation, need for lesser number of intravitreal injections and a trend towards better functional outcomes.
比较有或无人工晶状体（IOL）取出情况下处理迟发性轻度眼内炎的结果。
印度南部的三级眼科护理研究所。
回顾性比较病例系列。
该研究纳入了1990年1月至2019年1月期间所有白内障手术后迟发性眼内炎的病例。比较了IOL未取出组和IOL取出组的眼内炎发生时间、症状持续时间、就诊时视力、进行IOL取出的时间、取出后的炎症消退情况、玻璃体内注射次数以及最终视力。
共有115只眼，IOL未取出组61只眼，IOL取出组54只眼。两组在年龄（分别为58.37±14.05岁和56.04±14.96岁；p = 0.35）、就诊时视力（分别有29.5%和29.6%的眼视力>20/400；p = 0.98）以及随访时间（分别为14.38±16.05，中位数8.5个月和7.06±3.55，中位数6个月；p = 0.43）方面无统计学显著差异。IOL未取出组和IOL取出组在炎症消退时间（分别为92.70±36.28天和45.33±11.2天；p<0.0001）和玻璃体内注射次数（分别为4.57±0.75，中位数5次和2.79±2.11，中位数2次；p = 0.005）方面存在统计学显著差异。IOL未取出组和IOL取出组在6个月时持续性/复发性炎症的发生率分别为18.03%和5.55%（p = 0.04）。IOL未取出组和取出组的良好功能结局发生率分别为50.81%和68.51%（p = 0.05）。
迟发性眼内炎中取出IOL有助于炎症更早消退，减少玻璃体内注射次数，并呈现出功能结局更好的趋势。
