[1]周恩亮,柯根杰,顾永昊,等.保留或取出人工晶状体的玻璃体切割术在白内障术后感染性眼内炎中的疗效分析[J].眼科新进展,2020,40(2):141-143.[doi:10.13389/j.cnki.rao.2020.0033]
 ZHOU Enliang,KE Genjie,GU Yonghao,et al.Comparative analysis of vitrectomy with preservation or removal of IOL in the treatment of infectious endophthalmitis after cataract surgery[J].Recent Advances in Ophthalmology,2020,40(2):141-143.[doi:10.13389/j.cnki.rao.2020.0033]
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保留或取出人工晶状体的玻璃体切割术在白内障术后感染性眼内炎中的疗效分析/HTML
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
40卷
期数:
2020年2期
页码:
141-143
栏目:
应用研究
出版日期:
2020-02-05

文章信息/Info

Title:
Comparative analysis of vitrectomy with preservation or removal of IOL in the treatment of infectious endophthalmitis after cataract surgery
作者:
周恩亮柯根杰顾永昊董凯
230001 安徽省合肥市,中国科学技术大学附属第一医院(安徽省立医院)
Author(s):
ZHOU EnliangKE GenjieGU YonghaoDONG Kai
First Affiliated Hospital of University of Science and Technology of China(Anhui Provincial Hospital),Hefei 230001,Anhui Province,China
关键词:
玻璃体切割术术后眼内炎白内障人工晶状体
Keywords:
vitrectomypostoperative endophthalmitiscataractintraocular lens
分类号:
R776.1
DOI:
10.13389/j.cnki.rao.2020.0033
文献标志码:
A
摘要:
目的 对比及分析保留或取出人工晶状体的玻璃体切割术治疗白内障术后感染性眼内炎的临床特征,探讨不同手术方式的影响因素及其有效性和安全性。方法 对2015年7月至2018年7月于中国科学技术大学附属第一医院眼科行23G玻璃体切割手术治疗的白内障术后感染性眼内炎患者43例(43眼)的临床资料进行回顾性分析。根据玻璃体切割术中是否摘出人工晶状体,将所有患者分为保留人工晶状体组(21例21眼)及取出人工晶状体组(22例22眼)。术后随访3~6个月,观察手术效果,并比较两组间患者的年龄、性别、患眼眼别、手术前后最佳矫正视力(best corrected visual acuity,BCVA)及术后并发症等的差异。结果 所有患者术后感染均得到控制。保留人工晶状体组BCVA术前为(2.57±1.20)logMAR,术后为(1.60±1.22)logMAR;取出人工晶状体组BCVA术前为(3.12±0.71)logMAR,术后为(1.95±1.08)logMAR。两组患者术后BCVA均较术前显著提高,差异均有统计学意义(均为P<0.05)。两组间患者的年龄、性别、患眼眼别、合并疾病情况、眼内液培养阳性率、手术医师级别、术中硅油填充的比例等比较,差异均无统计学意义(均为P>0.05),术前及术后BCVA两组间差异均有统计学意义(均为P<0.05)。结论 玻璃体切割术是治疗白内障术后感染性眼内炎的重要、有效方法。患者术前BCVA的高低可能是影响术者作出是否保留人工晶状体决定的一个重要因素。
Abstract:
Objective To compare and analyze the clinical characteristics of infective endophthalmitis after cataract surgery treated by vitrectomy with intraocular lens (IOL) preservation or removal,and to explore the influencing factors of different surgical methods and their effectiveness and safety.Methods From July 2015 to July 2018,43 consecutive patients (43 eyes) with infective endophthalmitis after cataract surgery treated by 23G vitrectomy in the First Affiliated Hospital of University of Science and Technology of China were enrolled and retrospectively analyzed in this study.They were divided into IOL preservation group (21 eyes) and IOL extraction group (22 eyes) according to whether the IOL was removed during vitrectomy.All patients were followed up for 3-6 months.The surgical results were recorded.The clinical features such as age,gender,side of affected eye,best corrected visual acuity (BCVA) before and after surgery were collected and compared between the two groups.Results Infection was improved in all patients after surgery.For patients in IOL preservation group,BCVA were (2.57±1.20)logMAR before surgery and (1.60±1.22)logMAR after surgery;for patients in IOL extraction group,BCVA were (3.12±0.71)logMAR before surgery and (1.95±1.08)logMAR after surgery.There were significant differences in visual improvement after surgery for both two groups (all P<0.05).There was no difference in age,gender,side of affected eye,incidence of complication disease,positive rate of bacterial culture,level of surgeons and ratio of silicone oil filling during surgery between the two groups (all P>0.05).However,significant difference was found in BCVA between the two groups before and after surgery (both P<0.05).Conclusion Vitrectomy is an important and effective surgery for the treatment of infectious endophthalmitis after cataract surgery.BCVA before surgery may be a key factor in determining whether the surgery retains IOL or not.

参考文献/References:

[1] JABBARVAND M,HASHEMIAN H,KHODAPARAST M,JOUHARI M,TABATABAEI A,REZAEI S.Endophthalmitis occurring after cataract surgery:outcomes of more than 480 000 cataract surgeries,epidemiologic features,and risk factors[J].Ophthalmology,2016,123(2):295-301.
[2] KESSEL L,FLESNER P,ANDRESEN J,ERNGAARD D,TENDAL B,HJORTDAL J.Antibiotic prevention of postcataract endophthalmitis:a systematic review and meta-analysis[J].Acta Ophthalmol,2015,93(4):303-317.
[3] FANG Y T,CHIEN L N,NG Y Y,CHU H F,CHEN W M,CHENG C Y,et al.Association of hospital and surgeon operation volume with the incidence of postoperative endophthalmitis:Taiwan experience[J].Eye,2006,20(8):900-907.
[4] ENDOPHTHALMITIS VITRECTOMY STUDY GROUP.A randomized trial of immediate vitrectomy and of intravenous antibiotics for the treatment of postoperative bacterial endophthalmitis[J].Arch Ophthalmol,1995,113(12):1479-1496.
[5] COMBEY DE LAMBER A,CAMPOLMI N,CORNUT P L,APTEL F,CREUZOT-GARCHER C,CHIQUET C,et al.Baseline factors predictive of visual prognosis in acute postoperative bacterial endophthalmitis in patients undergoing cataract surgery[J].JAMA Ophthalmol,2013,131(19):1159-1166.
[6] JEONG S H,CHO H J,KIM H S,HAN J I,LEE D W,KIM C G,et al.Acute endophthalmitis after cataract surgery:164 consecutive cases treated at a referral center in South Korea[J].Eye,2017,31(10):1456-1462.
[7] HSU C M,CHEN S C,WU T T,SHEU S J.Outcomes of 23-gauge transconjunctival sutureless vitrectomy for acute postoperative endophthalmitis[J].J Chin Med Assoc,2017,80(8):503.
[8] RECCHIA F M,BUSBEE B G,PEARLMAN R B,CARVALHO-RECCHIA C A,HO A C.Changing trends in the microbiologic aspects of postcataract endophthalmitis[J].Arch Ophthalmol,2005,123(3):341-346.
[9] BAILLIF S,ECOCHARD R,CASOLI E,FRENEY J,BURILLON C,KODJIKIAN L.Adherence and kinetics of biofilm formation of Staphylococcus epidermidis to different types of intraocular lenses under dynamic flow conditions[J].J Cataract Refract Surg,2008,34(1):153-158.
[10] OKAJIMA Y,KOBAYAKAWA S,TSUJI A,TOCBIKUBO T.Biofilm formation by Staphylococcus epidermidis on intraocular lens material[J].Invest Ophthalmol Vis Sci,2006,47(7):2971-2975.
[11] 颜华,陈松,张静楷,于国金,韩金栋.白内障术后眼内炎保留人工晶状体的治疗[J].中华眼科杂志,2009,45(8):684-687.

YAN H,CHEN S,ZHANG J K,YU G J,HAN J D.Treatment of postoperative endophthalmitis following cataract surgery without intraocular lens removal[J].Chin J Ophthalmol,2009,45(8):684-687.
[12] 中华医学会眼科学分会白内障及人工晶状体学组.我国白内障摘出手术后感染性眼内炎防治专家共识(2017年)[J].中华眼科杂志,2017,53(11):810-813.

Cataract and Intraocular Lens Group of Ophthalmology Division of CMS.Expert consensus on prevention and treatment of infectious endophthalmitis after cataract extraction in China(2017)[J].Chin J Ophthalmol,2017,53(11):810-813.

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备注/Memo:
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更新日期/Last Update: 2020-02-05