硅油填充术在不伴有视网膜脱离外伤性感染性眼内炎的临床应用  

Clinical Study of Pars Plana Vitrectomy with Silicone Oil Endotamponade in Posttraumatic Endophthal-mitis on Eyes without Retinal Detachment

作　　者：汪振芳[1] 董诺[1] 康瑛[1] 刘小红[1] 曹乾忠[1] 梁丹[1] 林晓峰[1] 

机构地区：[1]中山大学中山眼科中心中山大学眼科学国家重点实验室,广州510060

出　　处：《眼科学报》2007年第1期48-52,共5页Eye Science

摘　　要：目的:观察玻璃体切除联合眼内注药或硅油填充术对眼球穿通伤后合并感染性眼内炎不伴视网膜脱离的疗效。方法:应用经睫状体平坦部玻璃体切除术,以联合眼内注药或硅油填充术分组治疗30只眼球穿通伤并发感染性眼内炎不伴有视网膜脱离患者,术后予以静脉、结膜下及眼药水途径给予抗感染抗炎治疗。结果:玻璃体切除术后追踪随访3～12个月,2组30只眼细菌性感染全部控制,术后视力较术前视力有显著性提高,联合眼内注药组19只眼,其中4只眼(21.1%)发生视网膜脱离;联合硅油填充组11只眼,其中术后1只眼(9%)发生视网膜脱离。两组术后并发症发生率均无明显差异(P>0.05)。结论:玻璃体切除联合硅油填充术能有效控制炎症,稳定视网膜功能,对一些视网膜情况不佳或炎症难以控制的患者可以考虑术中应用硅油。Purpose： To assess the clinical effect of pars plana vitrectomy （PPV） with intravitreous antibiotic drugs or silicone oil endotamponade in post-traumatic endophthalmitis on eyes without detachment of the retina. Methods： Thirty cases of eyes with penetrating injury associated with endophthalmitis without retina detachment had been treated with PPV plus intravitreous antibiotic drugs or silicone oil tamponade. All the patients in the study received intravenous, subconjunctival and topical medications antibiotics. Results： All the patients were followed up for 3 to 12 months. Postoperative intraocular infection of 30 eyes （ 30 patients） were controlled. The best-corrected visual acuity was significantly improved in both groups postoperatively （P 〈 0.05）. The rate of postoperative retinal detachment in the PPV combined with intravitreal antibiotics group was 21.1% （4/19）vs 9% （1/11）in the PPV combined with silicone oil endotamponade group. There was no significant difference in postoperative complications between two groups. Conclusions： PPV combined with silicone oil tamponade may have beneficial effect on the surgical treatment of traumatic bacterial endophthalmitis associated without retinal detachment, but the surgery may be used in some cases which have bad retinal condition or uncontrollable inflammation. Eye Science 2007; 23：48-52.

关 键 词：化脓性眼内炎 硅油 玻璃体切除术 并发症 

分 类 号：R779.6[医药卫生—眼科]