Casey Eye Institute, Oregon Health and Science University, Portland, Oregon.
Casey Eye Institute, Oregon Health and Science University, Portland, Oregon.
Ophthalmol Retina. 2021 Mar;5(3):279-284. doi: 10.1016/j.oret.2020.07.013. Epub 2020 Jul 17.
To determine the rate, clinical features, and outcomes of filtering-associated endophthalmitis in eyes that underwent trabeculectomy or tube-shunt implantation.
Retrospective database study with selective chart review.
Eyes that underwent incisional glaucoma surgery at our institution between January 1, 2012, and December 31, 2019.
An electronic medical record database was used to identify all eyes that underwent trabeculectomy or tube-shunt implantation during the study period. Date of surgery, date of last ophthalmology clinic visit, and filtering-associated endophthalmitis diagnoses were obtained and used to perform a Kaplan-Meier analysis. The log-rank test was used to compare rates of filtering-associated endophthalmitis after trabeculectomy and tube-shunt implantation. Microbiology, management, and clinical outcomes data from patients with filtering-associated endophthalmitis were also collected and analyzed.
Cumulative risk of filtering-associated endophthalmitis as determined by Kaplan-Meier analysis. Visual acuity improvement to within 2 lines of baseline at 3 months of follow-up and globe salvage at last available follow-up in eyes with filtering-associated endophthalmitis.
Kaplan-Meier analysis of 1582 eyes that underwent incisional glaucoma surgery yielded a 5-year cumulative incidence for filtering-associated endophthalmitis of 1.32%. No statistically significant differences were found between rate of endophthalmitis after trabeculectomy or tube-shunt implantation (P = 0.761, log-rank test). Seven of 16 cases (43.8%) of filtering-associated endophthalmitis showed positive culture results from either a vitreous sample or explanted tube shunt. Recovery of vision to within 2 lines of pre-endophthalmitis baseline was achieved in 53% of patients at 3 months of follow-up. Rate of globe salvage was 100% at last available follow-up.
Risk of filtering-associated endophthalmitis is persistent and relatively constant for at least 5 years after incisional glaucoma surgery. The overall prognosis of filtering-associated endophthalmitis remains poor; however, good visual and anatomic outcomes can be achieved in some patients with prompt intervention.
确定在接受小梁切除术或管分流植入术后发生滤过相关性眼内炎的发生率、临床特征和结局。
回顾性数据库研究，选择性图表回顾。
在我们机构接受切开性青光眼手术的眼睛，时间在 2012 年 1 月 1 日至 2019 年 12 月 31 日之间。
使用电子病历数据库确定研究期间接受小梁切除术或管分流植入术的所有眼睛。获取手术日期、最后一次眼科就诊日期和滤过相关性眼内炎的诊断，并进行 Kaplan-Meier 分析。对数秩检验用于比较小梁切除术和管分流植入术后滤过相关性眼内炎的发生率。还收集和分析了滤过相关性眼内炎患者的微生物学、治疗和临床结局数据。
Kaplan-Meier 分析确定的滤过相关性眼内炎的累积风险。在 3 个月的随访中，视力提高到基线的 2 行以内，在滤过相关性眼内炎的最后一次随访中眼球存活。
对 1582 只接受切开性青光眼手术的眼睛进行 Kaplan-Meier 分析，得出 5 年累积滤过相关性眼内炎发生率为 1.32%。小梁切除术或管分流植入术后眼内炎发生率无统计学差异（P=0.761，对数秩检验）。16 例（43.8%）滤过相关性眼内炎中有 7 例的玻璃体样本或植入管分流中培养结果呈阳性。在 3 个月的随访中，53%的患者视力恢复到眼内炎前基线的 2 行以内。在最后一次随访时，眼球存活率为 100%。
切开性青光眼手术后至少 5 年内，滤过相关性眼内炎的风险持续且相对稳定。滤过相关性眼内炎的总体预后仍然较差；然而，及时干预可以使一些患者获得良好的视力和解剖学结局。
