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单日内玻璃体内注射后多例眼内炎患者行紧急玻璃体切除术、万古霉素输注、硅油内填塞及全身抗生素治疗——病例系列

Urgent Vitrectomy with Vancomycin Infusion, Silicone Oil Endotamponade, and General Antibiotic Treatment in Multiple Cases of Endophthalmitis from a Single Day of Intravitreal Injections-Case Series.

作者信息

Pietras-Baczewska Agata, Jasińska Ewa, Toro Mario Damiano, Bonfiglio Vincenza, Reibaldi Michele, Avitabile Teresio, Nowomiejska Katarzyna, Rejdak Robert

机构信息

Department of General Ophthalmology, Medical University of Lublin, 20-059 Lublin, Poland.

Faculty of Medicine, Collegium Medicum Cardinal Stefan Wyszyński University, 01-815 Warsaw, Poland.

出版信息

J Clin Med. 2021 Mar 4;10(5):1059. doi: 10.3390/jcm10051059.

Abstract

The aim of this study was to report on the anatomical and functional results of surgical management of seven cases of endophthalmitis related to a single day of intravitreal aflibercept injections. Patients with signs of endophthalmitis who underwent aflibercept injections (seven eyes) performed on the same day were retrospectively evaluated. The data of visual acuity and optical coherence tomography (OCT) within nine months of the follow-up and the treatment and results of microbiological cultures are reported. Four of the total seven cases had a positive bacterial culture outcome (. All patients underwent vitrectomy combined with phacoemulsification when the eyes were not pseudophakic, vancomycin infusion, and silicone oil tamponade within 24 h; additionally, systemic antibiotics were administered intravenously. The final best-corrected visual acuity (BCVA) after the treatment was finger counting or light perception in all cases, and all eyes were saved with disruption of the inner retinal layers and stabilization of the retina in regard to changes related to the wet age-related macular degeneration (AMD). Although the retinal anatomy was mostly preserved, most of the patients affected by -induced endophthalmitis did not regain baseline vision after the therapy.

摘要

本研究的目的是报告7例与玻璃体内注射阿柏西普同一天相关的眼内炎手术治疗的解剖和功能结果。对同一天接受阿柏西普注射(7只眼)且出现眼内炎体征的患者进行回顾性评估。报告随访9个月内的视力和光学相干断层扫描(OCT)数据以及微生物培养的治疗情况和结果。7例病例中有4例细菌培养结果呈阳性。所有患者在非人工晶状体眼时均在24小时内接受了玻璃体切除术联合超声乳化术、万古霉素输注和硅油填塞;此外,还静脉注射了全身抗生素。治疗后的最终最佳矫正视力(BCVA)在所有病例中均为手指计数或光感,所有眼睛均得以保留,视网膜内层出现破坏,视网膜在与湿性年龄相关性黄斑变性(AMD)相关的变化方面保持稳定。尽管视网膜解剖结构大多得以保留,但大多数受阿柏西普诱导的眼内炎影响的患者在治疗后并未恢复至基线视力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ada/7961493/66ec10886928/jcm-10-01059-g001.jpg

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