Department of Ophthalmology & Visual Sciences, University of Maryland School of Medicine, Baltimore, Maryland, USA.
John F. Hardesty, MD, Department of Ophthalmology & Visual Sciences, Washington University in St Louis School of Medicine, St Louis, Missouri, USA.
BMJ Case Rep. 2022 Dec 1;15(12):e251462. doi: 10.1136/bcr-2022-251462.
A woman presented two weeks after uncomplicated cataract surgery with decreased visual acuity from endophthalmitis. One week after initial management with intravitreal antibiotics, her visual acuity decreased further, undergoing pars plana vitrectomy with intravitreal and intravenous antimicrobial coverage with preliminary improvement. Three days after vitrectomy, her vision decreased with recurrent inflammation. Initial cultures grew She underwent repeat vitrectomy with silicone oil tamponade with no subsequent recurrence. The silicone oil was removed after 4 months and her visual acuity returned to 20/20 after 1 month and through 1 year of follow-up. Postoperative endophthalmitis is rare, with cases due to species particularly destructive. In this first reported case of endophthalmitis, conventional management did not achieve lasting quiescence until silicone oil tamponade was employed. Pars plana vitrectomy with silicone oil tamponade should be considered in the management of recurrent endophthalmitis or endophthalmitis secondary to a recalcitrant microbe.
一位女性在白内障手术后两周出现眼内炎导致视力下降。在最初接受玻璃体内抗生素治疗一周后,她的视力进一步下降,接受了玻璃体切除术,并进行了玻璃体内和静脉内抗菌药物覆盖,初步有所改善。玻璃体切除术后 3 天,她的视力因炎症复发而下降。最初的培养物生长 她接受了再次玻璃体切除和硅油填塞,但没有再次复发。4 个月后取出硅油,1 个月后视力恢复到 20/20,随访 1 年未见复发。术后眼内炎罕见,由 物种引起的病例特别具有破坏性。在首例报道的 眼内炎病例中,直到使用硅油填塞,常规治疗才达到持久的稳定。对于复发性眼内炎或由难治性微生物引起的眼内炎,应考虑行玻璃体切除术联合硅油填塞。