玻璃体切割联合注药治疗感染性眼内炎

目的分析玻璃体切割联合注药对感染性眼内炎的临床疗效。方法回顾性分析34例感染性眼内炎患者的临床资料。结果玻璃体切割组19例,视力提高7例,1例炎症不能控制眼球摘除;非玻璃体切割组15例,视力提高7例,4例炎症不能控制行眼球摘除。结论玻璃体切割联合玻璃体注药是治疗感染性眼内炎的有效方案。     

玻璃体切割联合玻璃体腔注药治疗感染性眼内炎的临床分析

目的 评估玻璃体切割联合玻璃体腔注药术对感染性眼内炎的治疗效果。方法 对感染性眼内炎患者18例(18只眼)施行玻璃体切割联合玻璃体腔注药术，并观察其疗效。结果 术后矫正视力提高11只眼，不变2只眼，降低4只眼。2例眼内感染未能控制，16例患者均炎症消退，角膜透明，前房清，眼球无萎缩。结论 玻璃体切割联合玻璃体腔注药术是治疗感染性眼内炎的有效手段。     

玻璃体切割联合玻璃体注药治疗眼内炎

对２８例２８眼化脓性眼内炎经平坦部行玻璃体切割联合玻璃体注药、眼内异物摘出,配合全身及局部应用抗生素、皮质类固醇药物或抗真菌药物治疗患者,回顾性分析了玻璃体切割联合玻璃体注药治疗化脓性眼内炎的临床应用价值。结果：随访６～１２月２８例２８眼眼内感染全部控制,２６眼视力有不同程度的提高,２眼眼球萎缩,无１眼眼球摘除。结论：玻璃体切割联合玻璃体注药是治疗化脓性眼内炎最有效方法。     

玻璃体切割联合玻璃体注药治疗眼内炎

目的 回顾性分析玻璃体切割联合玻璃体注药治疗化脓性眼内炎的临床应用价值。方法 对２８例２８眼化脓性眼内炎经平坦部行玻璃体切割联合玻璃体注药、眼内异物摘出,配合全身及局部应用抗生素、玻质类固醇药物或抗真菌药物治疗。结果 随访６～１２ｍｏ,２８例２８眼内感染全部控制,２６眼视力有没程度的提高,２眼眼球萎缩,无１眼眼球摘出。结论 玻璃体切割联合玻璃体注药是治疗化脓性眼内炎最有效方法。     

玻璃体手术治疗人工晶状体植入术后感染性眼内炎

目的分析总结人工晶状体植入术后感删性眼内炎的治疗效果。方法收治12例(12眼)人工晶状体植入术后感染性眼内炎。5眼行单纯玻璃体腔注药,6眼行玻璃体腔注药联合玻璃体切除,1眼行眼内容摘除术。结果早期玻璃体腔内注药或联合玻璃体切除可有效控制感染,11眼炎症控制,8眼最终视力达0.12~0.5。结论玻璃体腔内注药或联合玻璃体切除术是人工晶状体植入术后感染性眼内炎较安全、有效的治疗方法。     

玻璃体切割联合玻璃体腔注药治疗眼内炎28例

目的：评价玻璃体切割联合玻璃体腔注药治疗严重眼内炎的临床应用价值方法：回顾性分析经28例28眼严重眼内炎行平坦部玻璃体切割术联合玻璃体注药，眼内异物出，配合全身及局部应用抗生素、皮质类固醇药物治疗的临床资料。结果：随访6～12mo，28例28眼眼内感染全部控制。26眼视力不同程度的提高，2眼眼球萎缩。结论：玻璃体切割联合玻璃体腔注药是治疗化脓性眼内炎最有效方法。     

玻璃体切割联合眼内注药治疗外源性真菌性眼内炎的远期疗效分析

目的 观察玻璃体切割及眼内注药治疗外源性真菌性眼内炎的远期疗效。方法 对11例(11只眼)确诊为真菌性眼内炎者采取玻璃体切割联合玻璃体腔注药治疗，随访1～3年，观察其治疗效果。结果 11例中，有5只眼保存有用视力，眼前手动2只眼，光感1只眼，眼球萎缩2只眼，1只眼因术后疼痛行眼球摘除。结论 真菌性眼内炎的预后不佳，早期行玻璃体切割联合眼内注药，可拯救部分视力。     

玻璃体切割联合玻璃体腔注药治疗外伤性眼内炎36例

研究外伤性眼内炎的病原及玻璃体切割术联合玻璃体腔注药治疗外伤性眼内炎的临床疗效分析。 方法：对临床病历资料完整的36例行玻璃体切割联合玻璃体腔注药治疗外伤性眼内炎患者资料进行整理分析,比较患者术前术后视力,分析受伤原因及病原体培养结果。 结果：随访5~36mo,行玻璃体切割联合玻璃体腔注药的36例患者术后感染均得到有效控制,24例患者视力有不同程度提高,占67%。球内异物是最主要的致病原因。22例术中取玻璃体行微生物学检查,7例检查阳性,其中革兰氏阳性球菌3例,革兰氏阴性杆菌1例,真菌2例,混合感染1例。 结论：玻璃体切割联合玻璃体腔注药是治疗外伤性眼内炎的有效方法,玻璃体腔内注入有效药物是提高外伤性眼内炎治愈率的关键     

玻璃体切割治疗细菌性眼内炎的疗效观察

目的评估玻璃体切割治疗细菌性眼内炎的临床效果。方法收治22例细菌性眼内炎，抽吸前房水及玻璃体培养发现，常见的致病菌为葡萄球菌及枯草杆菌，采用玻璃体切割联合注药治疗眼内感染。结果治愈率为68％，总有效率为86％，3例丧失光感，占14％。结论玻璃体切割联合眼内注药是目前治疗眼内感染较为理想的方法。     

外因性化脓性眼内炎的病因和临床治疗分析

目的分析外因性化脓性眼内炎的病因构成及玻璃体注药和玻璃体切割术治疗的临床效果。方法对外因性化脓性眼内炎患者27例（28眼）的临床资料进行回顾性分析，并进行随访。结果眼球穿孔伤导致的眼内炎13眼，与白内障手术相关的眼内炎12眼，青光眼手术晚期滤泡感染2眼，玻璃体切割术后感染1眼。经玻璃体注药或联合玻璃体切割术治疗后，炎症控制眼球外形结构完整20眼，占71．43％，其中功能成功（视力≥0．02）18眼，占64．29％，均达脱盲（视力≥0．05）标准。结论眼球穿孔伤和白内障手术是目前导致外因性眼内炎的最主要原因，尽早行玻璃体注药或联合玻璃体切割术是治疗化脓性眼内炎的有效方法。     

白内障术后感染性眼内炎治疗11例

目的探讨白内障术后感染性眼内炎相关因素及治疗方法。方法对我院1999年11月至2005年10月11例11眼白内障术后感染性眼内炎进行回顾性分析。结果7眼细菌培养阳性，培养细菌包括：表皮葡萄球菌2眼，粪肠球菌1眼，催产克雷白菌1眼，腐生葡萄球菌1眼，异型枸橼酸杆菌1眼，醋酸不动杆菌1眼。行后部玻璃体切割术者5眼，其中眼球摘除1眼；单纯前房冲洗加注药2眼；前房冲洗注药联合玻璃体腔注药4眼。结论前房和玻璃体注药，后部玻璃体切割术是治疗的有效方法。     

开放性眼球外伤迟发型感染性眼内炎救治分析

目的探讨眼球开放伤迟发型感染性眼内炎的临床诊断、救治方案、疗效及预后。方法10例（10眼）不同原因的眼球穿孔伤引发的迟发型感染性眼内炎,根据病程长短、病情轻重等,对其中1例行玻璃体注药,1例行玻璃体注药联合前房冲洗,其余8例接受玻璃体切除联合其它治疗。结果10例中有6例经涂片或培养病原菌呈阳性。病原菌培养阳性病例中多数为毒力较弱的G＋或G-球菌或条件致病菌。1例阴沟肠杆菌感染者接受玻璃体注药联合前房冲洗后炎症未能控制并有迅速发展为全眼球炎的迹象,最终行眼内容摘除术,其余9例均得到有效救治,眼内炎症得到有效控制,其中5例达到0．1以上视力。结论开放性眼球外伤引发的迟发型感染性眼内炎比较少见,一般致病菌毒力较弱,症状较轻,容易被忽略,因此,及早发现和准确诊断至关重要,及时采取玻璃体手术等综合治疗可以有效控制炎症,明显提高治疗效果。     

玻璃体切除玻璃体腔注药治疗感染性眼内炎

目的评价玻璃体切除联合玻璃体腔注药治疗严重眼内炎的临床应用价值。方法对43例（43眼）感染性眼内炎进行玻璃体切除联合玻璃体腔注药、眼内异物摘出，或联合晶状体切除、视网膜脱离复位及硅油或惰性气体填充术，配合全身及局部应用抗生素（或抗真菌药）、皮质类固醇药物治疗。随访4月～4年。结果41眼（95．35％）眼内炎控制，保存了眼球；35眼（81．40％）视力不同程度的提高；视力无变化者3眼（6．98％）；视力降低3眼（6．98％）；1眼（2．33％）作眼内容摘除；1例术后自动出院，失随访。结论玻璃体切除联合玻璃体腔注药是治疗严重眼内炎的有效方法。     

Clinical Analysis of Cataract Surgery Complicated by Endophthalmitis

Purpose:.To assess the efficacy of vitrectomy combined with intravitreal injection in the treatment of endophthalmitis after phacoemulsification and IOL implantation. Methods:.Five patients.(5 eyes),.who had undergone conventional phacoemulsification combined with IOL implantation at another treatment facility,.presented with endophthalmitis. The subjects ranged in age from 41 to 79 years (65.8±0.5 years on average),.and three were male..All five cases received bacterial culture susceptibility testing..On the basis of the treatment of primary disease, 3 cases had anterior chamber irrigation,.and posterior vitrectomy followed by intravitreal injection of 1 mg vancomycin plus 2.25 mg ceftazidime. Results:.Four out of the five cases of endophthalmitis had a positive bacterial culture testing results.(two cases of staphylococcus epidermidis,.one case of enterococcus faecalis and one case of head-like staphylococcus),.and the remaining case had no bacterial growth..Four cases showed restored visual acuity,.clear vitreous cavity,.and no retinal detachment or other complications. Conclusion: Management of patients presenting with endophthalmitis subsequent to cataract surgery should include: prompt bacterial culture and drug sensitivity tests, and where appropriate, vitrectomy combined with intravitreal injection of vancomycin.     

白内障术后眼内炎的治疗分析

目的：探讨白内障术后眼内炎的治疗方案及效果。方法：对我院2006-01/2010-12白内障摘除术＋人工晶状体植入术的21973例28722眼患者的资料（超声乳化20937例27521眼,囊外摘除术1036例1201眼）进行回顾性分析。结果：在全部术眼中,感染性眼内炎11眼,感染率为0.04%,9眼发生于超声乳化术后,2眼发生于白内障囊外摘除术后。共有5眼病原菌培养阳性,其中表皮葡萄球菌2眼,金黄色葡萄球菌,浅绿色气球菌,真菌各1眼。感染发生于白内障术后2wk以内者占73%（8/11）,房水混浊或前房积脓者行前房灌洗＋玻璃体腔注射万古霉素;前房积脓合并明显玻璃体混浊或经前房灌洗＋玻璃体腔注射万古霉素治疗观察1～2d感染加重者行前房灌洗＋玻璃体切割术。治疗后11眼均保住眼球。结论：白内障术后眼内炎经常发生于白内障术后2wk以内,经及时有效的治疗可控制感染发展,保留部分有用视力;前房灌洗＋玻璃体腔注射万古霉素必要时联合玻璃体切割术是有效的治疗方法。     

玻璃体切除术及药物治疗内源性真菌性眼内炎

目的 探讨内源性真菌性眼内炎的临床特点和治疗效果.方法 对近5年来经玻璃体切除术治疗和病原学诊断的内源性真菌性眼内炎5例（5眼）的临床资料进行回顾性分析.结果 5例采用玻璃体切除术联合全身抗真菌药物治疗,感染控制,手术后视力4例提高,1例下降.术中采取玻璃体标本真菌培养5例均为阳性.结论 内源性真菌性眼内炎起病隐匿,危害视力严重.及时采取玻璃体切除术联合全身抗真菌药物治疗有助于病原诊断和控制感染.     

Management of Infectious Endophthalmitis

Diagnostic anterior chamber and vitreous aspiration confirmed an infectious etiology in 78 of 140 eyes (56%) with suspected endophthalmitis. In 27 eyes the vitreous aspirate was positive, while the anterior chamber aspirate was negative. Intraocular antibiotics were used in 88 eyes including 50 which underwent therapeutic vitrectomy. Vision of 20/20 to 20/400 was achieved in 57% of recently operated, culture-positive eyes treated with intraocular antibiotics, and in 59% of those treated with combined vitrectomy and intraocular antibiotics.     

Etiology and diagnosis of bacterial postoperative endophthalmitis.

It is necessary to determine if postoperative endophthalmitis is of infectious or sterile etiology. Intraocular contents should be cultured and were positive in 50% of 58 eyes tested at our institute with suspected postoperative endophthalmitis. The vitreous aspirate is more sensitive than the anterior chamber aspirate in making a diagnosis. The use of a membrane filter to concentrate vitreous samples obtained at vitrectomy increases diagnostic yield. Fifty percent of culture-positive eyes yielded gram-positive organisms. Stained smears were consistent with the cultured organism in half of the cases.     

Treatment of acute and chronic endophthalmitis following posterior chamber lens implantation

Nine cases of postoperative endophthalmitis following extracapsular cataract extraction with implantation of a posterior chamber lens are presented -5 acute cases which occurred 3 to 5 days after surgery, and 4 subacute to chronic cases which occurred between 7 weeks and 18 months postoperatively. Experience has shown that in acute cases it is advisable, in addition to massive topical and parenteral therapy with antibiotics, to perform an emergency extraction of the posterior chamber lens and anterior or pars plana vitrectomy. In the subacute to chronic cases a step-by-step approach appears sensible: conservative treatment with massive topical and parenteral antibiotics and topical steroids; if this fails, removal of the lens, leaving the diaphragm in situ provided that the vitreous is not excessively infiltrated; if this also fails or there is extensive infiltration of the vitreous, removal of the posterior chamber lens with the capsular bag and vitrectomy with protection by antibiotics.     

THE PLACE FOR VITRECTOMY IN POSTERIOR SEGMENT INFECTION*

The paper reviews experience with vitrectomy in five cases of endophthalmitis in which vision was severely reduced because of vitreous opacification. In two of the cases vitrectomy was performed after the infection had been aborted, and in three of the cases vitrectomy was performed during the stage of acute endophthalmitis when there was evidence that the condition was not responding to conservative medical treatment. In all cases, vitrectomy resulted in a dramatic improvement in vision. It is suggested that vitrectomy represents a major advance in the management of bacterial and fungal endophthalmitis.