青光眼薄壁滤过泡相关性眼部感染临床分析

目的:分析和探讨青光眼滤过术后薄壁滤过泡相关性眼部感染发生的危险因素,临床特点,处理和防治方法。方法:回顾性分析2002-06/2007-12我科收治的由于薄壁滤过泡产生相关并发症的患者的临床资料。结果:共收集10例青光眼滤过手术后薄壁滤过泡感染患者的资料。其中,单纯滤过泡感染7例,滤过泡伴眼内炎3例。感染发生于术后1～24mo不等。所有患者均使用过丝裂霉素(MMC),病原学培养阳性率为50%,以革兰氏阳性球菌为主。感染病例经药物治疗,感染控制良好。所有病例均予手术治疗,术后滤过泡薄壁状况改善,视力提高,眼压控制良好。结论:薄壁滤过泡与滤过泡感染及迟发性滤过泡相关性眼内炎的发生密切相关,MMC的使用是导致薄壁滤过泡的重要原因。药物和手术治疗可以消除炎症,维持正常眼压,改善视力。

Blebitis and endophthalmitis associated with glaucoma thin-walled blebs

AIM:To evaluate the risk factors,clinical characteristics and the treatment methods of blebitis and endophthalmitis after glaucoma extra-filtering surgery.·METHODS:The medical records of all patients with blebitis and endophthalmitis after glaucoma extra-filtering surgery treated at our hospital affiliated to Panzhihua University from June 2000 to December 2007 were reviewed retrospectively.·RESULTS:Ten patients were collected,including seven of blebitis,three of endophthalmitis. All case had a thin-walled bleb. Mitomycin C was used for every patient. Conjunctival and vitreous cultures were performed in all blebitis and endophthalmitis. There were four cultures with staphylococcus epidermidis,one with staphylococcus aureus. After the treatments of topical antibitics and surgery,the status of thin-wall was improved,visual acuity was increased and IOP was well controlled. All patients had a good outcome.·CONCLUSION:The use of Mitomycin C is the important reason of the thin-walled blebs,and the thin-walled blebs are susceptible to infection. With the correct treatment,we will get good outcome.