眼科学报2024，Vol.39Issue(3)：113-119,7.DOI:10.12419/24031902
微创玻璃体切割术后急性眼内炎的临床分析
Clinical analysis of endophthalmitis after minimally invasive vitrectomy
摘要
Abstract
Objective:To analyze risk factors for endophthalmitis occurred after 23G/25G minimally invasive vitrectomy.Methods:Retrospective analysis of the clinical characteristics of patients with endophthalmitis(except patients with open eye trauma)after minimally invasive vitrectomy in General Hospital of Central Theater Command(Wuhan,430064)from June 2014 to May 2023.Results:This study included 8,955 patients,of which 11 cases occurred endophthalmitis after minimally invasive vitrectomy,with an incidence rate of 0.12%.The average age was(60.8±7.6)years,and 5 patients(45.4%)were complicated with diabetes;The composition of primary eye diseases:7 cases(63.6%)of macular disease,2 cases(18.2%)of vitreous hemorrhage secondary to proliferative diabetic retinopathy and 1 case(9.1%)vitreous hemorrhage secondary to retinal fissure,1 case(9.1%)of retinal detachment;During the operation,3 cases(27.3%)underwent combined cataract surgery;After the operation,8 cases(72.7%)were filled with sterile air in the vitreous cavity of affected eye,the other 3 cases(27.3%)were filled with equilibrium liquid,and sclera puncture incision was not sutured in all patients;3 cases(27.3%)had low intraocular pressure after operation.The time for postoperative endophthalmitis to occur after operation was 2.8±1.1day.11 patients had poor inflammation control after local and systemic anti-inflammatory treatments,and all underwent vitrectomy combined with intraoperative injection of vancomycin solution.Among them,9 patients were filled with silicone oil in the vitreous cavity after the surgery.After the operation,all the endophthalmitis were controlled and final corrected visual acuity of 10 patients improved.Conclusions:Minimally invasive vitrectomy and suture-free scleral incision may be a potential way for pathogenic microorganisms to invade the eye and cause endophthalmitis.Particular attention should be paid to the'Vitreous Wick Syndrome'at the scleral incision caused by incomplete vitrectomy in macular surgery,which may be one of the risk factors for postoperative endophthalmitis.关键词
微创玻璃体切割术/眼内炎/危险因素/临床分析Key words
minimally invasive vitrectomy/endophthalmitis/risk factors/clinical analysis分类
医药卫生引用本文复制引用
晏颖,向念,魏乔诺,喻娟,陈晓..微创玻璃体切割术后急性眼内炎的临床分析[J].眼科学报,2024,39(3):113-119,7.基金项目
中国人民解放军中部战区总医院育英计划面上项目(ID 1581).This work was supported by the project of Yuying Plan Project of Central Theater General Hospital(ID 1581). （ID 1581）
