前房注射抗生素预防白内障术后眼内炎的研究进展  

Advances on intracameral antibiotics to prevent endophthalmitis after cataract surgery

作　　者：刘建英 常笛 李婧[1] 万修华[1] Liu Jianying;Chang Di;Li Jing;Wan Xiuhua(Beijing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University,Beijing Key Laboratory of Ophthalmology and Visual Sciences,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院、北京同仁眼科中心、眼科学与视觉科学北京市重点实验室,100730

出　　处：《国际眼科纵览》2023年第2期115-120,共6页International Review of Ophthalmology

基　　金：国家自然科学基金(82171037);北京市医院管理中心临床医学发展专项经费(XMLX202133)。

摘　　要：前房注射抗生素是在白内障摘除术毕将少量抗生素注入到前房以预防白内障术后感染性眼内炎,最常用的药物是头孢呋辛、莫西沙星和万古霉素。头孢呋辛和万古霉素主要通过干扰细菌细胞壁的合成发挥抗菌作用,莫西沙星的作用机制为抑制Ⅱ、Ⅳ拓扑异构酶,干扰细菌的DNA复制、修复和转录。前房注射头孢呋辛和万古霉素的常规推荐剂量为1.0 mg/0.1 mL;莫西沙星迄今尚无标准剂量,在保证安全的前提下同时避免产生耐药性,建议应用剂量为0.5 mg/0.1 mL。前房注射抗生素预防白内障术后眼内炎的有效性已有大量临床研究证明,但并发症有待进一步研究。Intracameral injection of antibiotics is to inject a small amount of antibiotics into the anterior chamber after cataract extraction to prevent endophthalmitis.The most commonly used drugs are cefuroxime,moxifloxacin and vancomycin.Cefuroxime and vancomycin exert antibacterial effects mainly by interfering with the synthesis of bacterial cell walls.The mechanism of action of moxifloxacin is to inhibit II and IV topoisomerases,interfering with bacterial DNA replication,repair,and transcription.The conventional recommended dose for intracameral injection of cefuroxime and vancomycin is 1.0 mg/0.1 mL,while there is currently no standard dose for moxifloxacin.To avoid drug resistance while ensuring safety,the recommended dose of moxifloxacin is 0.5 mg/0.1 mL.The effectiveness of intracameral injection of antibiotics in preventing endophthalmitis after cataract surgery has been proven by a large number of clinical studies,but complications need to be further studied.

关 键 词：白内障/外科学 手术后并发症 眼内炎 前房注射 抗生素 

分 类 号：R779.66[医药卫生—眼科]