玻璃体切割术联合玻璃体腔注射抗菌素治疗细菌性眼内炎

玻璃体切割术联合玻璃体腔注射抗菌素治疗细菌性眼内炎湖北省孝感市中心医院眼科周太平，罗传堂，刘醇铸细菌性眼内炎对眼组织的损伤较重，传统的方法治疗效果较差。我院自１９８１年－１９９２年１１年间采用玻璃体切割术治疗细菌性眼内炎３２例３２眼，报告如下。临床资...     

玻璃体切割治疗外伤性眼内炎

外伤性眼内炎的治疗,以往多采取药物治疗,由于血－视网膜屏障的存在,效果多不满意,不仅可以丧失视力,甚至无法保留眼球。玻璃体手术的兴起和发展,为治疗眼内炎开辟了新的途径。１９９６年以来,我们运用玻璃体切割术治疗外伤性眼内炎２１例,取得了较好疗效,现总结...     

玻璃体切割手术治疗化脓性眼内炎

总结４４例化脓性眼内炎的玻璃体切割手术治疗，经过分析认为及时进行玻璃体切割手术，术中妥善处理显微镜下所见眼底病变，术后全身及局部联合应用抗生素及激素等药物是治疗化脓性眼内炎的关键。     

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。     

玻璃体切割术治疗外伤性眼内炎

目的:评价玻璃体切割联合眼内药物灌注治疗严重的外伤性眼内炎的临床效果.方法:回顾性分析30例(30眼)因外伤性眼内炎行玻璃体切除术,术中联合药物玻璃体腔灌注的患者.结果:术后 3mo 29 眼炎症得到控制,眼球得以保留,28眼视力有不同程度提高.眼内异物是最常见的受伤原因,金黄色葡萄球菌是最常见的细菌.结论:及时行玻璃体切割术联合眼内药物灌注是治疗外伤性眼内炎的有效方法.     

玻璃体切割术治疗外源性眼内炎15例

眼内炎是眼内组织的明显炎症反应,由微生物引起的眼内炎称感染性眼内炎。病菌所释放毒素与炎症介质可能在短期内严重破坏眼内组织而产生不可逆后果,治疗不及时会导致视功能丧失,眼球萎缩。我院从2005年以来应用玻璃体切割术治疗外源性眼内炎取得良好效果,现报告如下。1资料与方     

玻璃体切除治疗外伤性化脓性眼内炎

目的回顾性分析玻璃体切除治疗外伤性化脓性眼内炎的临床价值。方法对32例外伤性化脓性眼内炎行玻璃体切除、环扎及Ⅰ期联合晶状体切除、眼内异物摘出、视网膜复位术，配合全身、局部应用抗生素、皮质类固醇治疗。结果随访6－24月，32例眼内感染全部控制。29例不仅保存了眼球，视力亦有不同程度的提高，3例眼球萎缩。术后6例发生机网膜脱离，其中5例Ⅱ期行视网膜复位联合硅油注入术，术后视网膜复位，并于术后5－12月行硅油取出术，4例视网膜复位，1例视网膜再脱离。结论玻璃体切除联合应用抗生素是外伤性化脓性限内炎治疗的有效方法。     

Endophthalmitis: A review of recent trends

Endophthalmitis is a feared complication of trauma, surgical procedures and septicemia. Although uncommon, its potential for significant visual loss is well recognized. Especially over the past decade, complicated surgeries and medical techniques have increased and seriously ill patients are being sustained in ever increasing numbers. New pathogens are being recognized and known ones reclassified thanks to advances in molecular analysis. Continuously evolving PCR methodologies also add a new dimension to the diagnosis of infectious endophthalmitis. As well, medical literature is now truly international, encompassing studies from around the world that expand our understanding of ocular infectious disease. This report reviews some of these changes as they relate to endophthalmitis and particularly to the spectrum of organisms involved.     

玻璃体切除治疗真菌性眼内炎

目的：探讨真菌性眼内炎的治疗及其预后。方法：回顾性分析真菌性眼内炎18例18只眼，经玻璃体切除或人工角膜下行玻璃体切除联合角膜移植及玻璃体腔注药。结果：随访6-12月，2眼0．1以上。9眼手动至0．05，l眼无光感，6眼行眼球摘除或则除术。结论：真菌性眼内炎预后不良，但玻璃体切除联合玻璃体腔注药是目前治疗真菌性眼内炎最有效的方法。     

Sympathetic Ophthalmia Following Vitrectomy for Endophthalmitis After Intravitreal Bevacizumab

Purpose: To describe a case of sympathetic ophthalmia following vitrectomy for endophthalmitis after an intravitreal injection of bevacizumab. Design: Retrospective case report. Methods: An 84-year-old male developed sympathetic ophthalmia 4 months after vitrectomy for endophthalmitis following an intravitreal injection. The inciting blind eye was enucleated. Results: Histopathology demonstrated sympathetic ophthalmia and phacoanaphylactic endophthalmitis. Visual acuity improved from 20/200 to 20/30 in the sympathizing eye with a combination of oral prednisone and azathioprine. Conclusions: Sympathetic ophthalmia can develop following exogenous endophthalmitis but has a good visual prognosis with appropriate treatment.     

Vitrectomy for Endogenous Fungal Endophthalmitis

Purpose: The purpose of this study was to evaluate the predisposing risk factors and treatment outcomes of endogenous fungal endophthalmitis (EFE). Methods: Records of 25 patients (29 eyes), diagnosed with EFE and treated at Shanghai Eye, Ear, Nose & Throat Hospital from January 2002 to December 2006, were retrospectively reviewed. Four patients had bilateral disease. Final visual acuity and recurrence of EFE were evaluated. Results: Of these 25 patients diagnosed with EFE, 20 patients (22 eyes) were treated by pars plana vitrectomy. Of the remaining 5 patients (7 eyes), 3 cases (4 eyes) were cured by antifungal drugs through systemic treatment and intravitreal injection, but another 2 cases (3 eyes) were only given intravitreal injection because of severe general conditions. Of the 22 eyes that underwent pars plana vitrectomy, 16 (73%) eyes gained visual acuity of counting fingers or better. Recurrent EFE was happened in 2 eyes. Vitrectomy was repeated in 1 eye, another was subsequently enucleated due to phthisis. Vitreous culture-proven or smear-proven EFE occurred in 27 or 2 eyes, respectively. Candida albicans occurred in 17 of 29 eyes (59%), and other causative organisms were yeast fungus (3 eyes), Aspergillus niger (3 eyes), Actinomyces (2 eyes),Aspergillus flavus (1 eye), and Fusarium (1 eye). Conclusion: Candida albicans were the most common causative organisms in EFE. The most common predisposing risk factors include recent major operation and intravenous administration in rural settings. Most patients with EFE will gain useful vision (counting fingers) after pars plana vitrectomy.     

The Role of Vitrectomy in the Management of Fungal Endophthalmitis

ABSTRACT

Fungal endophthalmitis is an important cause of vision loss worldwide with a large body of literature describing the treatment of the disease. The evidence supporting the use of pars plana vitrectomy in the management of fungal endophthalmitis is largely comprised of case reports and case series and demonstrates the important role of vitrectomy surgery. Vitrectomy can improve the likelihood of establishing the diagnosis, enhance the treatment of infection by removing fungal elements in the vitreous, aid in the removal of other inoculated intraocular structures, and is an important tool in the management of vision-threatening post-infectious sequelae like retinal detachment and epiretinal membrane.     

Diagnostic Ultrasound and Pars Plana Vitrectomy in Endophthalmitis

Purulentendophthalmitisistheinfectiousinflammationofeye.Whensevereendophtha鄄lmitisoccurs,vitreousbodyisofteninvolved,whichshowsopaqueandabscessformation.Whentheuveaandretinaareinvolved,theyshowswelling,ischemiaandexudates.Whenthelensisinvolved,itshowedopaqueanddegener鄄ated.Inclinical,mediaopacitiessuchastheex鄄udatesinanteriorchamber,cataractorcornealinfiltrationprecludetheophthalmoscopicevalua鄄tionofvitreousbody,whichmayaffectthedeci鄄sionofsurgery.B鄄scanultrasonographycanpro鄄videmuchin…     

玻璃體切割术治疗化膿性眼内炎48例

目的 評價玻璃體切割術治療化膿性眼内炎的療效。方法 48例化膿性眼内炎及時采用玻璃體切割術,術后全身及局部應用廣譜、高效抗生素和皮質類固醇治療。結果 術后隨訪3-36月,全部保住眼球,炎症得到控制,視力均有不同程度的提高,矯正視力:0.7以上4例,占8.3％,0.6-0.3者10例,占20.8％,0.2-0.1者15例。占31.3％,0.09-0.01者17例占35.4,無光感2例。占4.2％。結論 玻璃體切割術治療化膿性眼内炎是目前較合理和有效的方法。     

儿童细菌性眼内炎的治疗

采用玻璃体切除和玻璃体内注射抗生素，治疗３０例儿童细菌性眼内炎。结果：治疗的效果与治疗时机、细菌毒力的大小、眼外伤的程度等因素有直接关系。细菌培养结果：７０％为球菌感染，３０％为杆菌感染，且８０％的细菌用庆大霉素治疗有效。