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）

Clinical analysis of bacterial endophthalmitis after IOL implantation

Objective To evaluate the treatment methods of endophthalmitis after IOL implantation. Design Retrospective case series. Participants 15 patients with endophthalmitis after IOL implantation treated by Beijing Xuanwu Hospital in 2002-2008. Meth-ods Vancomycin was injected into vitreous cavity in all patients. Vitrectomy was performed on the patient whose infective bacteria could not be controlled by intravitreal injection. Main outcome measures Infective status, visual function, results of microbiological exami-nation. Result Endophthalmitis occured in 13 cases (86.6%) after 72 hours of cartaract surgery. Microbiological examination was per-formed on 15 cases (aqueous or vitreous sample), 6 cases showed positive results, in which 4 cases were staphylococcus epidermidis. The infection of 12 patients (80%) were controlled with intravitreal injection and 10 patients gained final visual acuity better than 0.1. Three patients received vitrectomy because infective bacteria can not be controlled. Conclusion Staphylococcus epi. may be the major cause of subacute endophthalmitis after cartaract surgery. Antibiotics injected immediately into vitreous cavity can control the infections in most cases.(Ophthalmol CHN, 2009, 18: 270-272)