CAJ | 학술논문

目的探讨人工晶状体(IOL)植入术后细菌性眼内炎治疗的方法.设计回顾性病例系列.研究对象宣武医院2002-2008年治疗的IOL植入术后眼内炎患者15例15眼.方法所有患者先采用玻璃体腔注射抗生素治疗,如果炎症不能被控制注药后24小时行玻璃体切除术.主要指标眼内感染情况,视力,病原学检查结果.结果 13例(86.6%)在术后72小时后发病.均进行了前房水或玻璃体标本的病原学检查,6例培养阳性,4例为表皮葡萄球菌.经玻璃体注入万古霉素等治疗,12例(80%)炎症被控制,其中10例视力恢复到0.1以上.3例炎症不能控制进行了玻璃体切除术.结论表皮葡萄球菌可能是亚急性IOL术后眼内炎的主要原因,及时的玻璃体腔注射抗生素治疗能控制大部分IOL植入术后的眼内炎.
목적 탐토인공정상체(IOL)식입술후세균성안내염치료적방법.설계회고성병례계렬.연구대상선무의원2002-2008년치료적IOL식입술후안내염환자15례15안.방법 소유환자선채용파리체강주사항생소치료,여과염증불능피공제주약후24소시행파리체절제술.주요지표안내감염정황,시력,병원학검사결과.결과 13례(86.6%)재술후72소시후발병.균진행료전방수혹파리체표본적병원학검사,6례배양양성,4례위표피포도구균.경파리체주입만고매소등치료,12례(80%)염증피공제,기중10례시력회복도0.1이상.3례염증불능공제진행료파리체절제술.결론 표피포도구균가능시아급성IOL술후안내염적주요원인,급시적파리체강주사항생소치료능공제대부분IOL식입술후적안내염.
Objective To evaluate the treatment methods of endophthalmitis after IOL implantation. Design Retrospective case series. Participants 15 patients with endophthalmitis after IOL implantation treated by Beijing Xuanwu Hospital in 2002-2008. Meth-ods Vancomycin was injected into vitreous cavity in all patients. Vitrectomy was performed on the patient whose infective bacteria could not be controlled by intravitreal injection. Main outcome measures Infective status, visual function, results of microbiological exami-nation. Result Endophthalmitis occured in 13 cases (86.6%) after 72 hours of cartaract surgery. Microbiological examination was per-formed on 15 cases (aqueous or vitreous sample), 6 cases showed positive results, in which 4 cases were staphylococcus epidermidis. The infection of 12 patients (80%) were controlled with intravitreal injection and 10 patients gained final visual acuity better than 0.1. Three patients received vitrectomy because infective bacteria can not be controlled. Conclusion Staphylococcus epi. may be the major cause of subacute endophthalmitis after cartaract surgery. Antibiotics injected immediately into vitreous cavity can control the infections in most cases.(Ophthalmol CHN, 2009, 18: 270-272)