儿童经巩膜后房型人工晶状体缝线固定术后感染性眼内炎的临床分析  

Clinical characteristics analysis of infective endophthalmitis after trans-scleral suture fixed posterior chamber intraocular lens in children

作　　者：蔡萌[1] 丁相奇[1] Cai Meng;Ding Xiangqi(Department of Ophthalmology,the Second People’s Hospital of Zhengzhou,Zhengzhou 450006,China)

机构地区：[1]郑州市第二人民医院眼科,450006

出　　处：《临床眼科杂志》2022年第2期134-137,共4页Journal of Clinical Ophthalmology

摘　　要：目的分析儿童经巩膜后房型人工晶状体缝线固定术后感染性眼内炎的临床表现。方法回顾性病例研究。对2017年12月至2019年12月本院收治的10例(10只眼)经巩膜后房型人工晶状体缝线固定术后感染性眼内炎患儿的临床资料进行分析。观察其发病特征、治疗方法、治疗前后最佳矫正视力(BCVA)等情况。结果10例患儿中8例出现不同程度的巩膜缝线暴露情况,所有患儿均接受玻璃体内注射抗生素。感染严重的患者行玻璃体切除术,5例患儿接受单纯玻璃体切除术,2例玻璃体切除联合硅油填充及1例联合气体填充。术后随访12个月,8例患儿术后视力提高,1例视力无改善,1例患儿视力下降。患儿治疗后BCVA明显提高,差异有统计学意义(P<0.05)。结论线结暴露是引起儿童经巩膜后房型人工晶状体缝线固定术后感染性眼内炎的重要原因,严格处理手术细节,开发改良手术方式,对于预防此类眼内炎的发生具有重要意义。Objective To analyze the clinical features of infective endophthalmitis after trans-scleral suture fixed posterior chamber intraocular lens in children.Methods Retrospective case study.The clinical data of 10 children(10 eyes)who were diagnosed with infectious endophthalmitis after trans-scleral suture fixed posterior chamber intraocular lens from December 2017 to December 2019 were retrospectively analyzed.The onset features,treatments,best corrected visual acuity(BCVA)and surgical complications were analyzed.Results Of all 10 patients,8 patients with exposure of suture knot to different levels.All cases received intravitreal antibiotics injection.Patients with severe infection underwent vitrectomy.5 cases were only treated with vitrectomy,2 cases underwent vitrectomy combined with silicone oil tamponade and 1 case underwent combined with gas tamponade.After 12 months follow up,the visual acuity was improved in 8 patients,1 patient unchanged and 1 patient decreased.The postoperative BCVA was improved as compared to the preoperative BCVA(P<0.05).Conclusions The exposure of suture knot was a significant cause of infective endophthalmitis of trans-scleral suture fixed posterior chamber intraocular lens in children.Strictly handing surgical details and developing improved surgical methods were significant to prevent endophthalmitis.

关 键 词：眼内炎 儿童 经巩膜后房型人工晶状体缝线固定术 

分 类 号：R779.6[医药卫生—眼科]