Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.
Retina. 2021 Nov 1;41(11):2310-2317. doi: 10.1097/IAE.0000000000003176.
To determine the mechanism of infection, clinical features, and risk factors of endophthalmitis after scleral fixation of an intraocular lens.
We included 15 patients with infectious endophthalmitis after scleral fixation of an intraocular lens between April 2004 and December 2017, as well as four patients found through a literature search. Thus, a total of 19 patients were analyzed.
Among 19 eyes, infectious endophthalmitis developed at a mean of 23 months (range: 1 day-10 years) after scleral fixation surgery. Nine eyes (47.4%) had early-onset endophthalmitis (≤6 weeks), and 10 eyes (52.6%) had delayed-onset endophthalmitis (>6 weeks). Eleven eyes (57.9%) had presumed microbial influx due to suture exposure. Those with delayed-onset endophthalmitis showed a higher rate of suture-related infection (80.0% vs. 33.3%) and culture of gram-negative bacteria (70.0% vs. 12.5%) than did those with early-onset endophthalmitis.
Infectious endophthalmitis can develop late after scleral fixation of an intraocular lens, usually related to the exposed sutures, and the visual prognosis is poor. Eyes that have sutured scleral fixation should be monitored regularly, and preventive measures should be performed if an exposed suture is found.
确定眼内透镜巩膜固定术后眼内炎的感染机制、临床特征和危险因素。
我们纳入了 2004 年 4 月至 2017 年 12 月间 15 例眼内透镜巩膜固定术后感染性眼内炎患者，以及通过文献检索发现的 4 例患者。因此，共分析了 19 例患者。
19 只眼中，巩膜固定术后平均 23 个月（1 天至 10 年）发生感染性眼内炎。9 只眼（47.4%）为早发性眼内炎（≤6 周），10 只眼（52.6%）为迟发性眼内炎（>6 周）。11 只眼（57.9%）因缝线暴露而推测存在微生物流入。迟发性眼内炎的缝线相关感染发生率（80.0%比 33.3%）和革兰氏阴性菌培养阳性率（70.0%比 12.5%）均高于早发性眼内炎。
眼内透镜巩膜固定术后可出现迟发性眼内炎，通常与暴露缝线有关，视力预后较差。有缝线固定巩膜的眼应定期监测，如发现缝线暴露应采取预防措施。
