Tianjin Eye Hospital, Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Institute, Clinical College of Ophthalmology Tianjin Medical University, Tianjin, China.
Department of Ophthalmology, Tianjin Medical University General Hospital, No. 154 Anshan Road, Tianjin, 300052, China.
BMC Ophthalmol. 2020 May 27;20(1):208. doi: 10.1186/s12886-020-01476-z.
There are no data available regarding the complications associated with using antibiotic ointment at the end of intraocular surgery. This study aimed to explore the necessity of using ocular tobramycin-dexamethasone prophylactically at the end of intraocular surgery.
This was a retrospective cohort study of patients who received intraocular surgery at Tianjin Medical University General Hospital from January 2015 to December 2017. The patients were grouped according to whether they received tobramycin-dexamethasone eye ointment or not after surgery. The Tobramycin dexamethasone eye ointment was sampled to observe bacterial contamination pathogens at 0.5, 1, 1.5, 2, 2.5, 3, 6, 8, 24, 36, 48, 72, and 168 h after being opened.
A total of 3811 eyes in 3811 patients (mean age of 63 ± 12 years) were included: 2397 eyes that received prophylactic tobramycin-dexamethasone eye ointment and 1414 eyes that did not. The overall rate of endophthalmitis was 0.08% (3/3811) in our study, all in the eye ointment group (0.12%, 3/2397); no patients developed endophthalmitis in the non-ointment group (0%, 0/1414)(P = 0.184). The anterior chamber reactions 1 day after surgery were more serious in the eye ointment group compared with the non-ointment group (all P < 0.05), but there were no statistically significant differences at 1 month postoperatively (all P > 0.05). The contamination rate was 0% at all time points over 7 days.
We did not observe a statistically significant difference in the incidence of endophthalmitis in patients with or without prophylactic tobramycin-dexamethasone eye ointment. And tobramycin-dexamethasone eye ointment seemed to increase some side effects such as eye secretions increasing and foreign body feeling.
目前尚无关于眼内手术后使用抗生素眼膏相关并发症的数据。本研究旨在探讨在眼内手术后预防性使用妥布霉素地塞米松眼膏的必要性。
这是一项回顾性队列研究，纳入 2015 年 1 月至 2017 年 12 月于天津医科大学总医院接受眼内手术的患者。根据术后是否使用妥布霉素地塞米松眼膏将患者分为两组。对妥布霉素地塞米松眼膏进行采样，观察在打开后 0.5、1、1.5、2、2.5、3、6、8、24、36、48、72 和 168 小时时的细菌污染病原体。
共纳入 3811 只眼（3811 例患者；平均年龄 63±12 岁）：2397 只眼预防性使用妥布霉素地塞米松眼膏，1414 只眼未使用。本研究中眼内炎的总发生率为 0.08%（3/3811），均发生在眼膏组（0.12%，3/2397）；非眼膏组无一例发生眼内炎（0%，0/1414）（P=0.184）。眼膏组术后第 1 天的前房反应比非眼膏组更严重（均 P<0.05），但术后 1 个月时无统计学差异（均 P>0.05）。7 天内所有时间点的污染率均为 0%。
我们未观察到预防性使用妥布霉素地塞米松眼膏的患者与未使用患者的眼内炎发生率存在统计学差异。而且妥布霉素地塞米松眼膏似乎增加了一些副作用，如眼分泌物增多和异物感。
