人工晶状体植入术后感染性眼内炎的治疗

目的 探讨白内障摘出联合人工晶状体植入术后感染性眼内炎的治疗效果。方法 对12例白内障摘出联合人工晶状体植入术后并发感染性眼内炎患者进行前房冲洗、玻璃体切除和玻璃体腔内注药及其它综合治疗。结果 11眼眼内炎症得到控制，1眼因炎症不能控制而行眼内容摘除。8眼视力有不同程度提高。结论 目前临床上对白内障摘出术后，感染性眼内炎的治疗首选方法是前房冲洗和早期玻璃体切除联合玻璃体腔内注入适量广谱抗生素，术后配合中西药物综合治疗。     

白内障超声乳化术后急性眼内炎分析

目的探讨白内障行晶状体超声乳化吸出术后眼内炎的发生、预防和治疗方法。方法回顾性分析8例（8眼）经临床和／或微生物检查证实为白内障术后眼内炎的临床资料。所有病例经临床诊断和房水、玻璃体涂片,并做细菌及真菌培养和药敏试验。结果8例中有6例房水及玻璃体微生物检查阳性（球菌5例,杆菌1例）。1例玻璃体腔注药病情控制;5例行玻璃体切除等手术联合注药,术中同时行人工晶状体摘出术者3例;1例行眼内容摘除术;1例保守治疗无效放弃治疗。治疗后视力2眼0．5,1眼0．2,3眼手动。术后随访6～24个月,随访到6例患者治疗前与治疗后视力呈正相关。结论白内障术后眼内炎及时有效的治疗可控制炎症,保留部分有用视力。     

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效果.方法 回顾性分析19例（19只眼）经临床和/或微生物检查证实为白内障术后眼内炎的临床资料.所有病例均行房水和玻璃体涂片和细菌/真菌培养＋药敏.结果 19例中术前有糖尿病史4例,高血压合并中度肾衰1例,泌尿系感染1例.19例中急性眼内炎16例,迟发性眼内炎3例.房水和玻璃体微生物检查阳性8例（阳性率42.11%）,其中球菌6例,杆菌1例,真菌1例.19例中15例行玻璃体切割联合玻璃体注药术,3例行前房冲洗和玻璃体注药术,1例行眼内容剜除术.14/15患眼炎症可控制,1例眼球萎缩外,16例保住眼球,最终视力＞0.05者9例.结论 白内障术后眼内炎及时有效的治疗可控制炎症,保留部分有用视力.     

人工晶状体植入术后急性眼内炎

目的 探讨白内障摘出联合人工晶状体植入术后急性眼内炎的临床特点、治疗方法及效果.方法 回顾性分析5848例白内障摘出人工晶状体植入术后发生急性眼内炎4例(4眼),眼内炎发生于术后2～6d,视力为光感～数指/10 cm.治疗方法:2例行玻璃体腔内注药术,其中1例效果欠佳,于次日行玻璃体切除联合玻璃体内注药;另2例行玻璃体切除术联合玻璃体腔内注药,均配合全身及局部应用抗生素及皮质类固醇类药物.结果 随访8～26个月,4例眼内炎均得到控制,最后视力分别为0.15、0.25、0.6、0.8.结论 白内障摘出人工晶状体植入术后急性眼内炎是白内障手术的严重并发症,玻璃体切除联合玻璃体腔注药是一种安全、有效的治疗方法.     

玻璃体切割治疗白内障术后眼内炎疗效观察

目的探讨白内障术后眼内炎的临床特点及治疗方法。方法分析5例（5眼）白内障术后眼内炎的治疗方法。结果5眼白内障术后眼内炎经玻璃体切割术，并辅以全身及局部抗生素治疗，眼内炎症得到控制，视力得到不同程度改善。结论白内障术后眼内炎是白内障手术的严重并发症，玻璃体切割术联合玻璃体腔内注药是一种有效的治疗方法，把握手术时机可以最大限度挽救患者视力，保全眼球。     

白内障术后急性眼内炎

目的 :探讨白内障术后急性眼内炎的临床特点及治疗方法。方法 :回顾性分析 4例 (5眼 )白内障术后急性眼内炎的治疗经过及病原学特点。结果 :5眼白内障术后急性眼内炎经玻璃体切割术及玻璃体腔注药后 ,并辅以全身及局部抗菌素治疗 ,眼内炎症得到控制 ,5眼最后视力得到不同程度改善 ,细菌培养为表皮萄葡球菌 3眼 ,金黄色萄葡球菌 1眼 ,施氏假单胞菌 1眼 ,这些细菌均对万古霉素、妥布霉素、庆大霉素及头孢他定 (复达欣 )敏感。结论 :白内障术后眼内炎是白内障手术的严重并发症 ,玻璃体切割术联合玻璃体腔内注药是一种有效的治疗方法。     

眼内异物摘出联合白内障摘出人工晶状体植入

目的 评价眼内异物伴外伤性白内障行异物摘出联合白内障摘出人工晶状体植入术的临床疗效。方法 对25例(25眼)眼内异物伴外伤性白内障依异物的位置不同而采用3种术式：采用玻璃体切除(9眼)或磁铁吸出玻璃体异物(10眼)，联合晶状体超声乳化及折叠人工晶状体植入；或经角膜缘切口摘出晶状体内异物联合囊外摘出PMMA人工晶状体后房植入(6眼)。结果 随访3月，术后视力≥0．515眼，0．1～0.48眼，0.082眼。术后视力低的主要原因是眼铁质沉着症。术后视力与角膜伤口的大小部位有关，与视网膜异物与黄斑区的距离有关。术后无眼内炎或视网膜脱离的发生。结论 准确判定预后、排除眼内炎视网膜脱离的因素而行眼内异物摘出联合人工晶状体植入是可行的。     

眼内炎玻璃体切除术的效果及预后因素的Cox分析

目的 探讨玻璃体切除术治疗外源性眼内炎的中、远期效果及预后因素.方法 回顾性分析40例（40眼）行玻璃体切除术的外源性眼内炎的临床资料,首先对中、远期疗效进行分析,然后对预后因素进行多元Cox回归分析（Cox比例风险回归模型）.结果 术后患者视力较术前有显著改善（P＜0.05）.术后1周出现不同程度的角膜水肿及前房炎症渗出物;2周后炎症反应缓解、积脓基本消失;3-6月随访期间均未见复发或炎症扩散,7例,于硅油刺激出现后囊浑浊.经多元Cox分析,并发性白内障、视网膜血管炎、晶状体摘出术、术前眼压及术后1周视力,均为影响眼内炎预后的相关因素.结论 玻璃体切除术治疗外源性眼内炎的疗效显著,视力明显提高;影响眼内炎的主要因素包括并发性白内障、视网膜血管炎、晶状体摘出术、术前眼压以及术后1周视力,应对其加以重视,以改善患者预后情况.     

玻璃体切除术在眼后段异物摘出术中的应用

目的评价玻璃体切除术在眼后段眼内异物摘出术中的效果。方法回顾分析2002年5月～2004年8月32例（32眼）运用玻璃体切除术联合眼球内后段异物摘出术的临床资料。结果32例均一次手术成功，伴有白内障者均经平坦部入路切除浑浊的晶状体，未一期植入人工晶状体，伴有视网膜脱离者均术中复位，伴有眼内炎者均治愈。12例术后视力提高，10例术后视力无变化，10例术后视力下降。结论玻璃体切除术可以有效、准确地摘出眼内异物，减少并发症发生。     

白内障术后感染性眼内炎的临床分析

目的探讨白内障摘出术后感染性眼内炎的发病因素、治疗方法及效果。方法回顾分析我院10年来,白内障术后眼内炎14例（14眼）的发病因素、治疗方法和后果。结果经过前房冲洗＋玻璃体腔注药和全身抗感染等治疗,所有患眼的感染均被控制,出院时视力1眼无光感;3眼光感;其余10眼均达数指以上。结论白内障术后眼内炎发病因素很多,早期前房冲洗＋玻璃体内注药是控制眼内炎,改善预后的关键,特别是对于无条件开展玻璃体手术的基层医院尤为重要。     

白内障术后眼内炎临床分析

目的探讨白内障术后发生眼内炎的临床危险因素和防治。方法收集连续白内障术后12600例进行回顾性分析。结果白内障术后眼内炎是由多因素导致的,包括患者自身条件,医生和医院因素,抗生素的应用,手术过程和人工晶状体材料等。结论采取相关防治措施对于白内障术后眼内炎的预防至关重要。     

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。     

Anaerobic bacterial endophthalmitis

Eighteen patients with endophthalmitis involving anaerobic bacteria are presented. Endophthalmitis followed cataract surgery in seven patients, penetrating trauma in six, a corneal graft in two, and an infected filtering bleb in two; there was one case of endogenous endophthalmitis. Propionibacterium acnes was the most frequent anaerobe isolated (78% of cases). Thirty-two percent of the patients had polymicrobial infection with mixed aerobic and anaerobic species. Six cases of acute P. acnes endophthalmitis were clinically indistinguishable from other cases of mild to moderately severe endophthalmitis. Four patients presented, after cataract surgery, with chronic, low-grade endophthalmitis of 1 to 15 months' duration, emphasizing that "sterile" endophthalmitis cannot be satisfactory diagnosed clinically. The visual prognosis of treated P. acnes endophthalmitis was often good. Based on principles of anaerobic microbiology, recommendations are made for vitreous collection, transport, and culture.     

人工晶状体植入术后细菌性眼内炎治疗的临床观察

目的探讨人工晶状体（IOL）植入术后细菌性眼内炎治疗的方法。设计回顾性病例系列。研究对象宣武医院2002—2008年治疗的IOL植入术后眼内炎患者15例15眼。方法所有患者先采用玻璃体腔注射抗生素治疗,如果炎症不能被控制注药后24小时行玻璃体切除术。主要指标眼内感染情况,视力,病原学检查结果。结果13例（86．6％）在术后72小时后发病。均进行了前房水或玻璃体标本的病原学检查,6例培养阳性,4例为表皮葡萄球菌。经玻璃体注入万古霉素等治疗,12例（80％）炎症被控制,其中10例视力恢复到0．1以上。3例炎症不能控制进行了玻璃体切除术。结论表皮葡萄球菌可能是亚急性IOL术后眼内炎的主要原因,及时的玻璃体腔注射抗生素治疗能控制大部分IOL植入术后的眼内炎。（眼科,2009,18：270-272）     

白内障术后眼内炎行玻璃体切除术的时机与疗效探讨

目的:探讨白内障术后眼内炎行玻璃体切除术的时机和疗效。方法:收集我院2003-07/2011-12的17例白内障超声乳化术后眼内炎患者行后段玻璃体切除的临床资料,男11例,女6例,术前视力:光感～0.1,治疗前常规抽取玻璃体送细菌、真菌培养加药物敏感试验。后段玻璃体切除手术后全身应用广谱抗生素及糖皮质激素治疗,随访3～24mo观察眼视力及眼部情况。结果:随访3～24mo,炎症无复发,末期随访眼部无炎症表现,玻璃体腔清亮。术后最佳矫正视力:0.02～0.05者6例,0.2～0.5者10例,1.0者1例。视力得到一定程度的恢复。结论:白内障超声乳化术后眼内炎行玻璃体切除能有效控制感染,确诊后立即行玻璃体手术是取得良好效果的关键。     

A comparison of endophthalmitis after phacoemulsification or extracapsular cataract extraction in a socio-economically deprived environment: a retrospective analysis of 2446 patients

PURPOSE: To assess which cataract operation technique involves least risk of postoperative endophthalmitis, when performed in a population living in poor hygiene conditions. METHODS: This retrospective clinical study evaluated 2446 cases at the Eye Clinic of the Komotini General Hospital, Greece, between January 1998 and January 2001. RESULTS: Endophthalmitis arose in 12/1055 patients (1.13%) after extracapsular cataract extraction (ECCE) and in 8/1391 after phacoemulsification (0.57%). The mean time to onset of endophthalmitis was 23 and 73 days respectively after phacoemulsification and ECCE. This difference was statistically significant. CONCLUSIONS: Endophthalmitis develops considerably later after ECCE than phacoemulsification. Thus it would appear that hygiene conditions have a stronger effect in patients operated with the ECCE technique. In order to reduce the risk of endophthalmitis after cataract extraction in patients living in substandard conditions, phacoemulsification is proposed as preferable to ECCE.     

Endophthalmitis after pars plana vitrectomy: a New Zealand experience

PURPOSE: To describe the clinical course and estimate the incidence of endophthalmitis after pars plana vitrectomy in New Zealand. METHODS: A retrospective analysis was performed on all cases of culture-positive endophthalmitis after vitreoretinal surgery over a 10-year period. RESULTS: Five cases of culture-positive endophthalmitis were identified between 1993 and 2002. During this interval, 10,397 vitrectomies were performed, equating to an overall incidence of 0.048%. All patients presented within 7 days of surgery. CONCLUSIONS: Endophthalmitis after pars plana vitrectomy is uncommon but is associated with a poor functional outcome.     

Endophthalmitis: a review of current evaluation and management

PURPOSE: To review the current state of evaluation and management of various forms of endophthalmitis. METHODS: A review of the literature is included, encompassing endophthalmitis occurring after ocular surgeries, intravitreal injection, trauma, and systemic infection. Based on this review, current principles and techniques for evaluating and treating these forms of endophthalmitis are discussed. RESULTS: Postoperative endophthalmitis after cataract surgery is the most common presentation. Conclusions from the Endophthalmitis Vitrectomy Study (EVS) remain a foundation for management of postcataract surgery endophthalmitis, notably prompt intravitreal antibiotic administration after vitreous sampling, with consideration for pars plana vitrectomy in severe cases. The potential impact of advances since the EVS, such as oral fourth generation fluoroquinolones and new vitrectomy techniques, are also discussed. The management of postcataract endophthalmitis is compared and contrasted to endophthalmitis occurring after other ocular surgeries, intravitreal injection, trauma, and systemic infection. Although some principles remain common, treatment rationales differ with other forms of endophthalmitis based on differing clinical circumstances, such as the virulence of organisms that are frequently encountered. CONCLUSIONS: Endophthalmitis is a serious, potentially vision threatening condition which can present in various settings. Prompt recognition and treatment are key in maximizing outcomes.     

Penetrating needle injury of the eye causing cataract in children

PURPOSE: To review the presentation, management, and outcome of children with cataract caused by ocular needle penetration. DESIGN: Retrospective, noncomparative interventional case series. PARTICIPANTS: Forty-two children with cataract caused by ocular needle penetration. INTERVENTION: Cataract surgery. MAIN OUTCOME MEASURES: Best-corrected postoperative visual acuity. RESULTS: Injuries were unintentional and occurred during unsupervised play. The type of needle involved was hypodermic in 24 cases, sewing in 7, and undetermined in 11. Endophthalmitis developed in 14 cases and retinal detachment in 6. Endophthalmitis occurred in 12 cases (50%) of hypodermic needle injury but in no case of sewing needle injury. With a mean postoperative follow-up of 2.3 years, the best-corrected visual acuity was 20/40 or better in 19 cases, 20/50 to 20/80 in 7, 20/100 to counting fingers in 6, light perception in 1, no light perception in 6, and undetermined in 3. Eyes with endophthalmitis and/or retinal detachment had a worse visual prognosis. CONCLUSIONS: Ocular penetration causing cataract occurred in children during unsupervised play with inadequately stored or disposed of hypodermic or sewing needles. Endophthalmitis occurred frequently in injuries caused by hypodermic needles but not in those caused by sewing needles. Visual outcome after management was good in approximately half of the cases especially if endophthalmitis or retinal detachment did not develop.