眼内注射贝伐单抗后发生克雷伯氏菌属簇生菌眼内炎：早期发现、经平坦部玻璃体切除术和前房内莫西沙星的作用。
Klebsiella Cluster Endophthalmitis following Intravitreal Bevacizumab: Role of Early Detection, Pars Plana Vitrectomy, and Intracameral Moxifloxacin.
机构信息
Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India.
SGHS Eye and Multispeciality hospital, Sohana, Mohali, Punjab.
出版信息
Ocul Immunol Inflamm. 2022 Jan 2;30(1):11-15. doi: 10.1080/09273948.2020.1808229. Epub 2020 Sep 23.
AIM
To report the clinical profile, outcomes of early vitrectomy for cluster endophthalmitis developing after intravitreal Bevacizumab (IVB), and discuss the role of prophylactic intracameral moxifloxacin for eyes undergoing combined cataract surgery with IVB.
METHODS
Single center, retrospective analysis of 35 consecutive eyes developing post-IVB inflammation.
RESULTS
Of the 35 eyes that were administered IVB (27 eyes 'IVB alone' and 8 eyes 'IVB with cataract surgery'). Endophthalmitis developed in 28 eyes, 6 eyes were managed with Intravitreal antibiotic (IVAB) alone, while 22 eyes required early vitrectomy. Only one eye undergoing a combined phacoemulsification with IVB developed endophthalmitis. Majority(26/28) of the eyes achieved visual acuity equal to/greater than pre-IVB injection vision over a period of 3.15 ± 3.2 months.
CONCLUSION
Early detection and prompt PPV were effectual for achieving good functional outcomes in our cluster of post-IVB Klebsiella endophthalmitis. Intracameral moxifloxacin was protective in cases undergoing combined cataract surgery with IVB.
目的
报告玻璃体腔内注射贝伐单抗（IVB）后发生簇状眼内炎的临床特征和治疗结果，并探讨在接受 IVB 联合白内障手术的患者中行预防性前房内注射莫西沙星的作用。
方法
回顾性分析单中心 35 例连续发生的 IVB 后炎症的病例。
结果
在接受 IVB 治疗的 35 只眼中（27 只眼为“IVB 单独治疗”，8 只眼为“IVB 联合白内障手术”），有 28 只眼发生眼内炎，其中 6 只眼仅行玻璃体腔内抗生素治疗，而 22 只眼需要早期玻璃体切除手术。仅在 1 只接受 IVB 联合白内障超声乳化术的眼中发生眼内炎。在 3.15±3.2 个月的时间内，大多数（26/28）眼的视力恢复到等于或优于 IVB 注射前的视力。
结论
在我们的一组 IVB 相关性肺炎克雷伯菌眼内炎病例中，早期发现和及时行玻璃体切割术对于获得良好的功能结果是有效的。对于接受 IVB 联合白内障手术的患者，前房内注射莫西沙星具有保护作用。
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