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N. Horio M. Horiguchi K. Murakami E. Yamamoto Y. Miyake 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2000,238(4):299-301
Background: Stenotrophomonas maltophilia is an opportunistic, gram-negative bacillus. Endophthalmitis induced by S. maltophilia has been described in only two cases after intraocular lens implantation. We report S. maltophilia endophthalmitis in two patients with diabetes mellitus after intraocular lens implantation and compare the characteristics of the S. maltophilia-induced endophthalmitis with two previous cases.Methods: A 68-year-old woman and a 74-year-old man with diabetes mellitus developed S. maltophilia endophthalmitis within 5 days of intraocular lens implantation. We performed intraocular lens removal and vitrectomy, which resolved the inflammation. No recurrences were found.Results: Cultures grew S. maltophilia in both cases, and one of the organisms was multiresistant. The final visual acuity was counting fingers and 0.3. The first case revealed a tractional retinal detachment during vitrectomy. Conclusions: S. maltophilia is a potential opportunistic intraocular pathogen, and the incidence of multiresistant S. maltophilia is increasing. S. maltophilia causes acute endophthalmitis, and its prognosis may not be poor unless the eye has a history of serious disease before the cataract surgery. The combined procedure of intraocular lens removal and vitrectomy was useful in resolving the inflammation and preventing recurrences. Received: 9 June 1999 Revised: 6 September 1999 Accepted: 22 September 1999 相似文献
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PURPOSE: To determine whether single flash electroretinograms can assist in the diagnosis of eyes with endophthalmitis after intraocular lens implantation. METHODS: Sixteen eyes with postoperative endophthalmitis treated with vitrectomy or intraocular lens removal were studied. The preoperative electroretinogram findings, duration until the onset of endophthalmitis, culture results, and postoperative visual acuity were analyzed. RESULTS: Four eyes with a b-wave/a-wave (b/a) ratio less than 1.0 and early onset of endophthalmitis within 1 week had worse postoperative visual acuity (no light perception to 20/200) than the other 12 eyes (20/100 to 20/15) (P =.0035). Pseudomonas aeruginosa and Enterococcus faecalis were cultured in these 4 eyes. CONCLUSION: The combination of a b/a ratio less than 1.0 and early onset of endophthalmitis may indicate poor prognosis in a patient with postoperative endophthalmitis. 相似文献
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Fungal endophthalmitis following intraocular lens implantation. 总被引:2,自引:0,他引:2
Endophthalmitis developed in a 61-year-pld man after an intraocular lens implantation. A whitish opacity developed, visual acuity decreased to light perception, and we enucleated the eye. Paecilomyces lilacinus (Thom) Samson, a saphrophyte that has contaminated laboratory solutions, was cultured. 相似文献
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儿童玻璃体切除术后无晶状体眼的二期人工晶体植入术 总被引:2,自引:0,他引:2
目的评价儿童玻璃体切除术后无晶状体眼二期人工晶体植入术的视力效果、手术技巧及其安全性.方法对32例儿童眼内炎玻璃体切除术后的无晶状体眼行人工晶状体植入术.采用颞下方平坦部巩膜灌注,行后房型人工晶体睫状沟缝线固定术,术后随访6~24月.结果所有患者均达到或超过术前最佳矫正视力,术后裸眼视力<0.1者2眼,0.1~0.2者8眼,0.2~04者16眼,>05者4眼.无严重远期并发症.结论儿童眼内炎玻璃体切除术后二期人工晶体睫状沟缝线固定术,手术效果可靠,术后并发症少,是矫正儿童无晶状体眼的理想手术方法. 相似文献
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Karl Ulrich Bartz-Schmidt Kathrin Tintelnot Michael Steffen Muhsin Özel Bernd Kirchhof Klaus Heimann 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》1996,234(9):591-593
Background: Basidiomycetes are known as rare pathogens for meningitis, sinusitis, pneumonia, ulcerative lesions of the hard palate and onychomycosis. To our knowledge, no filamentous basidiomycete has been reported from a case of fungal endophthalmitis. Patient: We report on a 67-year-old man with delayed-onset endophthalmitis caused by an opportunistic basidiomycete. Tissue obtained during vitrectomy was cultured and examined by light and transmission electron microscopy. After enucleation the eye was examined by light microscopy. Conclusion: The patient had endophthalmitis from a sterile hyphomycete, harboured in remnants of lens capsule and a granuloma on the ciliary body. It was recognized as a Holobasidiomycete on the basis of its dolipore structure with perforated pore cap, seen with transmission electron microscopy. Species identification was not possible because fruiting bodies were absent. The patient failed to respond to intravitreal and systemic amphotericin B and systemic itraconazole. The eye was enucleated. This case demonstrates that filamentous basidiomycetes can cause endophthalmitis when inoculated during cataract extraction. 相似文献
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Chronic Propionibacterium endophthalmitis after extracapsular cataract extraction and intraocular lens implantation 总被引:7,自引:0,他引:7
D M Meisler A G Palestine D W Vastine D R Demartini B F Murphy W J Reinhart Z N Zakov J T McMahon T P Cliffel 《American journal of ophthalmology》1986,102(6):733-739
We studied six cases of chronic, indolent intraocular inflammation that occurred after extracapsular cataract extraction and posterior chamber intraocular lens implantation. The inflammation was characterized by a delayed onset, and in three cases had the clinical appearance of a granulomatous iridocyclitis. Cultures of intraocular specimens obtained from six eyes yielded Propionibacterium; five yielded P. acnes. Pleomorphic gram-positive bacilli consistent with Propionibacterium were identified in cytologic or histopathologic studies in four of the six culture-positive cases. After surgical and medical therapy, the inflammation resolved. Postoperative Propionibacterium endophthalmitis may masquerade as a chronic iridocyclitis. 相似文献
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Staphylococcus epidermidis endophthalmitis following intraocular lens implantation. 总被引:4,自引:3,他引:1 下载免费PDF全文
A 90-year-old man developed a hypopyon following cataract extraction with intraocular lens implantation. The hypopyon cleared with topical corticosteroid therapy but recurred whenever the corticosteroid therapy was reduced. At surgery for the removal of the intraocular lens an opaque anterior vitreous membrane was excised. Cultures of the anterior vitreous grew Staphylococcus epidermidis. The diagnosis was further confirmed by the histology of the anterior vitreous membrane, which showed Gram-positive cocci in the macrophages and polymorphonuclear leucocytes. This case shows that corticosteroids may completely mask an endophthalmitis from an organism of low virulence such as Staphylococcus epidermidis. Endophthalmitis from an organism of low virulence should be considered in any case of persistent postoperative inflammation. 相似文献
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玻璃体切除联合白内障摘出人工晶状体植入术 总被引:3,自引:2,他引:3
目的探讨玻璃体切除联合白内障摘出及人工晶状体植入术的临床效果。方法对16例(17眼)玻璃体视网膜疾病伴有明显的白内障者实施了此联合手术。先行常规白内障囊外摘出术或晶状体超声乳化术,再行标准三通道闭合式玻璃体切除术,最后植入人工晶状体。结果术后随访2月~3年,平均13月。16眼术后视力均有不同程度提高,1眼增生性糖尿病性视网膜病变术后2月因继发新生血管性青光眼,行广泛视网膜冷凝后视力下降。术后早期16例(17眼)均有不同程度的角膜后弹力层皱褶,术后7~10d消失。2例(2眼)术后有一过性眼压升高。1例(1眼)术后2月发生新生血管性青光眼。3例(3眼)术后后囊浑浊,未影响视力。结论此联合手术的临床效果良好,具有一定的优点,但应严格掌握适应证,并要求有熟练的手术技巧。 相似文献
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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。 相似文献
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A 54-year-old male patient was seen in clinic for ocular pain and decreased vision in the right eye with duration of two days. He underwent a cataract operation for his right eye 12 years ago, then a sclera-fixated secondary intraocular implantation and pars plana vitrectomy three years ago due to intraocular lens dislocation. At the initial visit, his visual acuity was restricted to the perception of hand motion. An edematous cornea, cells, flare with hypopyon, and exposed suture material at were observed at the six o'clock direction by slit lamp. Vitreous opacity was noted from B-scan ultrasonography. The patient was diagnosed with late-onset endophthalmitis and an intravitreal cocktail injection was done. On the next day, the hypopyon was aggravated, and therefore a pars plana vitrectomy was performed. A vitreous culture tested positive for Citrobacter koseri. After 12 weeks, the best corrected visual acuity of the right eye improved to 0.7 and a fundus examination revealed a relatively normal optic disc and retinal vasculature. We herein report the first case of endophthalmitis caused by Citrobacter koseri in Korea. Exposed suture material was suspected as the source of infection in this case and prompt surgical intervention resulted in a relatively good visual outcome. 相似文献
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白内障超声乳化联合人工晶状体植入术后霉菌性眼内炎 总被引:5,自引:0,他引:5
目的:探讨白内障术后霉菌性眼内炎的发病过程及临床表现,希望有助于临床医师对该疾病的认识。方法:回顾性分析近年来我院5例白内障超声乳化联合人工晶状体植入术后发生霉菌性眼内炎的发病经过、临床表现、诊断治疗及预后等情况。5例于白内障术后30~50d确诊眼内炎后均急诊行前房冲洗、玻璃体切除硅油填充术。并于玻璃体切除术后局部及全身使用抗真菌类药物。结果:有2例行眼内容剜除术,3例术后3mo随访见眼球轻度萎缩,视力分别为光感和指数/眼前。结论:对内眼手术即使是眼前节手术术后迟发型眼内炎症反应或经正规抗生素、激素治疗病情反复者应想到有真菌感染的可能,及时抽取标本作细菌、真菌涂片、培养及药物敏感试验,争取能够早期诊断和治疗,最大限度保留有用视力和眼球。 相似文献
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Vitrectomy combined with phacoemulsification and intraocular lens implantation for diabetic macular edema 总被引:2,自引:0,他引:2
PURPOSE: The outcome of vitrectomy combined with phacoemulsification and intraocular lens implantation (PEA+IOL) for diabetic macular edema was evaluated. METHODS: Included in this study were 31 patients (42 eyes) with clinically significant diabetic macular edema, in whom posterior vitreous detachment was not observed. Pars plana vitrectomy combined with PEA+IOL was performed on 15 eyes. Sixteen phakic eyes and 11 pseudophakic eyes were followed up without vitrectomy as controls. Visual acuity and the state of macular edema were evaluated. RESULTS: After follow-up of 18 +/- 7 (mean +/- SD) months, clinically significant macular edema remained in 3 eyes (20%) of the vitrectomy group, in 11 eyes (69%) of the phakic control group, and in 9 eyes (82%) of the pseudophakic control group. The logarithm of the minimal angle of resolution (Log(MAR)) of the best-corrected visual acuity of the vitrectomy group eyes significantly improved from 1.09 +/- 0.27 to 0.80 +/- 0.35 (P <.01), while that of pseudophakic control eyes significantly decreased from 0.59 +/- 0.17 to 0.86 +/- 0.28 (P <.05). The Log(MAR) of phakic control eyes also decreased from 0.82 +/- 0.36 to 0.93 +/- 0.30, but there was no significant difference (P =.19). CONCLUSION: Vitrectomy combined with PEA+IOL is an effective surgical modality to improve visual acuity in eyes with clinically significant diabetic macular edema. 相似文献
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玻璃体切除联合白内障超声乳化加人工晶状体植入治疗增殖性糖尿病视网膜病变 总被引:1,自引:0,他引:1
目的探讨玻璃体切除手术联合白内障超声乳化摘除加人工晶状体(IOL)植入术治疗增殖性糖尿病视网膜病变的效果。方法回顾分析32例(35眼)增殖性糖尿病视网膜病变玻璃体切除联合超声乳化加IOL植入手术患者资料,其中5期病变19眼,6期病变16眼。术前视力为光感~0.2,中位数为数指,仅5眼(14%)术前视力1〉0.1。均在局部麻醉下手术,白内障手术均先于玻璃体手术。术后随访时间I〉3个月。对数据进行分类计数,求百分比。结果IOL均成功植入囊袋内。15眼采用了硅油或长效气体填充。术中并发症包括:4眼(11%)瞳孔缩小,1眼(3%)囊袋内少许晶状体皮质残留。术后并发症包括:1眼(3%)复发玻璃体积血,4眼(11%)虹膜后黏连。末次随访视网膜均保持复位,术后视力0.01~0.6(中位数013),34眼(97%)术后视力1〉0.1。结论玻璃体切除联合白内障超声乳化摘除加IOL植入术是治疗增殖性糖尿病视网膜病变的有效手段。具有较高的安全性,有助于患者视力早期恢复。 相似文献
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Packer M Fine IH Hoffman RS Piers P 《Journal of cataract and refractive surgery》2006,32(2):184-5; author reply 185-6
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目的:探讨儿童外伤性白内障眼内炎患者人工晶状体植入的手术时机。方法:本研究为前瞻性研究,入选病例为我院2003-06/2005-06收治的69例69眼儿童外伤性白内障眼内炎患者,术中观察玻璃体积脓不超过一个象限或仅累及前部玻璃体,视网膜状态完好者。将69例69眼患者随机分为两组,对两组患者采用不同手术方式进行治疗,A组34例34眼:进行玻璃体切除,同期植入人工晶状体;B组35例35眼:先进行玻璃体切除,术后3~6moII期植入人工晶状体。比较两种方法的治疗效果。结果:两组患者术后视力均明显提高。两组手术前后视力分别进行比较P=0.000,差别均有显著统计学意义;两组之间手术前后视力比较,术前P=0.978,差别无显著统计学意义;术后P=0.005,差别有显著统计学意义。A组患者术后视力明显好于B组。两组之间术后反应及并发症进行比较,差别无显著统计学意义。结论:在严格控制适应证的基础上,儿童外伤性白内障眼内炎患者,进行玻璃体切除同期植入人工晶状体,配合有效的术后处理,一般均能取得较好的治疗效果。 相似文献