Pham-Duy T, Wollensak J, Schnitzkewitz G
Universitätsaugenklinik im Klinkum Rudolf-Virchow, Standort Charlottenburg der Freien Universität Berlin.
Klin Monbl Augenheilkd. 1988 Sep;193(3):243-8. doi: 10.1055/s-2008-1050252.
Inflammatory reactions following cataract extraction and implantation of an intraocular lens are rare complications. In a group of 10,000 patients the incidence of toxic lens syndrome was 0.15%; infections were seen in 0.07% of the cases. Except for two patients with toxic lens syndrome associated with cystoid macular edema, all ultimately had good visual acuity. While toxic lens syndrome is seen in the first postoperative week or recurs at a later date and responds very well to corticosteroids, bacterial endophthalmitis usually develops on the first postoperative day, with fulminant progress. Mycotic infections occur after a longer interval and temporarily respond better to corticosteroids. The endophthalmitis should be treated early with a vitrectomy to eliminate micro-organisms and toxic agents, and to achieve a high intraocular level of antibiotics and antimycotics. From June 1982 to June 1987, thirteen patients with endophthalmitis after cataract extraction were vitrectomized. Navigating visual acuity was ultimately achieved in eight cases. Two patients developed a phthisis bulbi and one a recurrent mycosis. Thus, altogether, an inflammation-free eye with navigating visual acuity can be achieved in over 50% of cases.
白内障摘除及人工晶状体植入术后的炎症反应是罕见的并发症。在一组10000例患者中，毒性晶状体综合征的发生率为0.15%；感染见于0.07%的病例。除了两名伴有黄斑囊样水肿的毒性晶状体综合征患者外，所有患者最终视力均良好。毒性晶状体综合征见于术后第一周或在后期复发，对皮质类固醇反应良好，而细菌性眼内炎通常在术后第一天发生，进展迅猛。真菌性感染在较长时间间隔后发生，对皮质类固醇的暂时反应较好。眼内炎应早期行玻璃体切除术以清除微生物和毒性物质，并使眼内达到高浓度的抗生素和抗真菌药。1982年6月至1987年6月，13例白内障摘除术后发生眼内炎的患者接受了玻璃体切除术。8例最终获得了可导航视力。2例发生眼球痨，1例发生复发性真菌病。因此，总的来说，超过50%的病例可实现无炎症且具有可导航视力的眼睛。
