Guo Hai-Xia, Xie Ruo-Tian, Wang Yun, You Cai-Yun, Liu Yuan-Yuan, Meng Xiang-Da, Yu Jin-Guo, Yan Hua
Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin 300052, China.
Laboratory of Molecular Ophthalmology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin 300070, China.
Int J Ophthalmol. 2022 Jun 18;15(6):1011-1014. doi: 10.18240/ijo.2022.06.21. eCollection 2022.
To investigate the clinical features, causative organisms and effects of timely vitrectomy and silicone oil tamponade without intraocular lens (IOL) removal in the treatment of acute-onset endophthalmitis after cataract surgery (APCE).
We retrospectively analyzed the clinical features and microbiological factors in 10 eyes of 10 patients with APCE at Tianjin Medical University General Hospital from January 2010 to December 2018. Data on the clinical features, causative organisms, visual acuity, intraocular pressure (IOP) and complications were collected. The mean follow-up period was 25.5mo.
The mean age of the patients was 71.4y. The mean time between cataract surgery and the onset of endophthalmitis was 2.0d. Preoperative visual acuity ranged from no light perception to hand motion. After vitrectomy, the visual acuity increased in nine eyes (90%), and was unchanged in one eye (10%). A significant difference was observed between the mean preoperative (36.3±7.1 mm Hg) and postoperative IOP (14.9±4.3 mm Hg, <0.05). was isolated in 5 eyes, in 2 eyes, and in 1 eye. Postoperative complications mainly included fibrin exudates in the anterior chamber at the early stages in all eyes and temporary IOP elevation in one eye. No retinal detachment or ocular atrophy was observed during the follow-up period.
Under systemic antibiotic treatment and timely diagnosis, vitrectomy and silicone oil tamponade without IOL removal is a safe and effective method for APCE.
探讨白内障手术后急性发作性眼内炎（APCE）患者，在不取出人工晶状体（IOL）的情况下，进行及时玻璃体切割术和硅油填充的临床特征、致病微生物及疗效。
回顾性分析2010年1月至2018年12月在天津医科大学总医院就诊的10例APCE患者10只眼的临床特征和微生物学因素。收集临床特征、致病微生物、视力、眼压（IOP）及并发症等数据。平均随访时间为25.5个月。
患者平均年龄71.4岁。白内障手术至眼内炎发作的平均时间为2.0天。术前视力从无光感到手动。玻璃体切割术后，9只眼（90%）视力提高，1只眼（10%）视力未改变。术前平均眼压（36.3±7.1 mmHg）与术后平均眼压（14.9±4.3 mmHg，P<0.05）之间存在显著差异。5只眼分离出[具体微生物名称1]，2只眼分离出[具体微生物名称2]，1只眼分离出[具体微生物名称3]。术后并发症主要包括所有眼早期前房纤维蛋白渗出，1只眼眼压暂时升高。随访期间未观察到视网膜脱离或眼球萎缩。
在全身抗生素治疗和及时诊断的情况下，不取出IOL的玻璃体切割术和硅油填充是治疗APCE的一种安全有效的方法。
