超声乳化白内障吸除术后眼内容炎的治疗  

The management of the endophthalmitis following phacoemulsification

作　　者：童晓维[1] 赵培泉[1] 黄欣[1] 王文吉[1] 

机构地区：[1]复旦大学附属眼耳鼻喉科医院眼科

出　　处：《临床眼科杂志》2003年第5期393-395,共3页Journal of Clinical Ophthalmology

摘　　要：目的　研究超声乳化白内障吸除术并发眼内容炎的临床特点、治疗方式选择及效果。方法　对 2 0例(2 0只眼 )超声乳化白内障吸除术后并发眼内容炎患者行房水、玻璃体液微生物检查 ,根据病情选择玻璃体腔内注入广谱抗生素或行玻璃体切除术 ,术中决定人工晶状体是否取出 ,同时全身、局部广谱抗生素及糖皮质激素治疗 ,分析治疗前后的眼部变化。结果　 10例有阳性菌种培养结果。2例经玻璃体腔注药病情控制 ;1例行眼球摘除术 ;17例接受了玻璃体切除术 ,术中同时行 IOL取出术 12例 ,1例手术治疗无效行眼内容物剜出术。术后 6月～ 2 4月间共随访到 17例 ,其治疗前视力与治疗后视力呈正相关 (P <0 .0 5 ) ,治疗后视力与是否获得细菌阳性培养有关 (P<0 .0 5 )。结论　及时的玻璃体腔广谱抗生素注射及适时的玻璃体切除术仍可保存部分较理想的视功能 ,视力预后与细菌培养结果及治疗前视力有关。Objective To observe the clinical characteristics and effective treatment measures of the endophthalmitis after phacoemulsification. Methods 20 patients (20 eyes) with endophthalmitis following phacoemulsification had received intravitreal antibiotics and aqueous, vitreous tap. Some of them underwent vitrectomy and IOL removal according to their conditions. And all of them received systemic and local antibiotics as well as corticosteroids. Results At the 6-month to 24-month visit, 17 patients were followed. The visual acuity after the treatment has straight relation with that before the treatment(P<0.05)and is related to the microbe culture results(P<0.05) . Conclusions Immediate intravitreal antibiotics, aqueous and vitreous tap, and appropriate vitrectomy can salvage useful vision in some of patients. The prognosis of visual acuity is related to the results of microbe culture and the initial visual acuity.

关 键 词：超声乳化 白内障吸除术 眼内容炎 治疗 临床特点 术后并发症 视功能 

分 类 号：R771.3[医药卫生—眼科]