玻璃体切割手术联合眼内填充治疗重症眼内炎的疗效观察  

Therapeutic effects of vitrectomy combined with endotamponade for severe endophthalmitis

作　　者：刘艳[1] 陈松[1] 付妍[1] 关禹博[1] 

机构地区：[1]天津市眼科医院,300020

出　　处：《中华眼底病杂志》2010年第5期427-430,共4页Chinese Journal of Ocular Fundus Diseases

摘　　要：目的 观察玻璃体切割手术联合眼内填充治疗重症眼内炎的临床效果.方法 回顾分析临床确诊为重症眼内炎的66例患者66只眼的临床资料.其中,外伤性重症眼内炎44例44只眼,内眼手术后重症眼内炎22例22只眼.所有患者均行玻璃体切割手术联合眼内填充治疗.66只患眼中,手术中摘除球内异物者19只眼,摘除晶状体者25只眼,摘除人工晶状体者6只眼,巩膜环扎者16只眼;行硅油填充者52只眼,行C3F8填充者14只眼.手术后随访时间2.0～25.0个月,平均随访时间7.9个月.对比分析手术前后视力和眼压变化情况.结果 所有患者炎症均得到控制,治疗有效率为59.10%.随访期间无眼内炎复发和视网膜脱离发生.66只患眼中,58只眼视力提高,占87.90%;5只眼视力不变,占7.60%;3只眼视力下降,占4.55%.手术后视力较手术前明显提高,差异有统计学意义（x2=45.27,P＜0.05）.手术后眼压较手术前增高,差异也有统计学意义（t=-3.23,P=0.02）.结论 玻璃体切割手术联合眼内填充是治疗重症眼内炎的有效方法.Objective To observe the effects of vitrectomy combined with endotamponade on severe endophthalmitis. Methods The clinical data of 44 patients （44 eyes） of posttraumatic and 22 patients （22 eyes） of postoperative severe endophthalmitis were retrospectively analyzed. All patients were treated by vitrectomy and endotamponade. Intraocular foreign body removal （19 eyes）, lens extraction （25 eyes）,intraocular lens removal （six eyes） and scleral buckling （16 eyes） were performed. Tamponade with silicone oil （52 eyes） or C3F8 gas （14 eyes） was also performed. Postoperative follow-up ranged from two to 25 months, with the mean of 7.9 months. The visual acuity（VA）and intraocular pressure before and after surgery were comparatively analyzed. Results Inflammation of all the patients were controlled,the effective rate was 59.10%. There was no recurrence and retinal detachment. Among the 66 eyes, postoperative VA of 58 eyes （87. 90 % ） increased, five eyes （ 7.60 % ） didn＇t change and three eyes （4.55% ） decreased, the difference was statistically significant（x2= 45.27, P〈0. 05）. The postoperative intraocular pressure was higher than that before surgery, the difference was statistically significant （t =- 3.23, P 〈 0.05）.Conclusions Vitrectomy combined with endotamponade is an effective way to cure severe endophthalmitis.It can improve the visual acuity and intraocular pressure.

关 键 词：眼内炎/外科学 眼内炎/病因学 玻璃体切除术 硅油类/治疗应用 

分 类 号：R779.6[医药卫生—眼科]