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白内障手术后急性感染性眼内炎:2008 - 2019年的流行病学特征、危险因素及发病趋势

Acute Infectious Endophthalmitis After Cataract Surgery: Epidemiological Characteristics, Risk Factors and Incidence Trends, 2008-2019.

作者信息

Sun Jiajun, Guo Zhen, Li Honglei, Yang Baoxia, Wu Xiaoming

机构信息

Qingdao Eye Hospital of Shandong First Medical University, Qingdao, 266071, People's Republic of China.

State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Qingdao, 266071, People's Republic of China.

出版信息

Infect Drug Resist. 2021 Mar 25;14:1231-1238. doi: 10.2147/IDR.S304675. eCollection 2021.

Abstract

OBJECTIVE

Intended to investigate the epidemiological characteristics, risk factors and incidence trend of endophthalmitis after cataract surgery in recent 12 years.

METHODS

A retrospective study was conducted on the patients who underwent cataract surgery in Qingdao Eye Hospital from January 1, 2008, to December 31, 2019, including age, sex, history of diabetes, intraoperative operation and complications. In addition, the related risk factors and incidence trend of acute infective endophthalmitis were analyzed. The incidence of endophthalmitis and its related factors were analyzed by univariate and multivariate logistic regression analysis.

RESULTS

A total of 55,612 cases of cataract surgery were performed in our hospital in 12 years, and 42 cases of acute infective endophthalmitis occurred (the incidence rate was 0.076%). The average occurrence time was 10.57 days ± 11.17, with eye pain as the main complaint and anterior chamber fibrin exudation as the main clinical manifestation. In addition, there were eight cases of anterior chamber hypopyon and 18 cases of vitreous reaction, the results of anterior aqueous humor or vitreous fluid culture in 10 patients were positive. Univariate analysis showed that intraoperative rupture of posterior capsule, non-use of antibiotics and non-use of behind-the-lens washout were the risk factors of infectious endophthalmitis after cataract surgery (P=0.032, P=0.000, P=0.000). Besides, multivariate logistic regression analysis showed that intraoperative rupture of posterior capsule was the main risk factor.

CONCLUSION

The occurrence of endophthalmitis after cataract surgery is mainly related to intraoperative rupture of posterior capsule, absence of antibiotics and behind-the-lens washout. In addition, the incidence of endophthalmitis after cataract surgery decreased during the past 12 years.

摘要

目的

旨在探讨近12年白内障手术后眼内炎的流行病学特征、危险因素及发病趋势。

方法

对2008年1月1日至2019年12月31日在青岛眼科医院接受白内障手术的患者进行回顾性研究,内容包括年龄、性别、糖尿病史、术中操作及并发症。此外,分析急性感染性眼内炎的相关危险因素及发病趋势。采用单因素和多因素logistic回归分析眼内炎的发生率及其相关因素。

结果

我院12年共行白内障手术55612例,发生急性感染性眼内炎42例(发生率为0.076%)。平均发病时间为10.57天±11.17天,主要症状为眼痛,主要临床表现为前房纤维蛋白渗出。此外,有8例前房积脓和18例玻璃体反应,10例患者的前房水或玻璃体液培养结果为阳性。单因素分析显示,术中后囊破裂、未使用抗生素及未行晶状体后冲洗是白内障手术后感染性眼内炎的危险因素(P=0.032,P=0.000,P=0.000)。此外,多因素logistic回归分析显示,术中后囊破裂是主要危险因素。

结论

白内障手术后眼内炎的发生主要与术中后囊破裂、未使用抗生素及未行晶状体后冲洗有关。此外,白内障手术后眼内炎的发生率在过去12年中有所下降。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8559/8007477/9d2a63d5fc7a/IDR-14-1231-g0001.jpg

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