内眼手术后感染性眼内炎的危险因素及预防措施

目的 探讨内眼手术后发生感染性眼内炎的危险因素及防范措施.方法 对2006年1月-2010年12月行内眼手术后发生感染性眼内炎的病例进行回顾性分析.结果 3887例内眼手术,术后发生感染性眼内炎15例,感染率为0.4％；其中行球内异物取出术后的最多12例,占80.0％,玻璃体切割手术后1例占6.7％,青光眼小梁手术后1例占6.7％,白内障手术后1例占6.7％；经积极抗感染球内注药及手术治疗后视力不同程度提高者12例占80.0％,视力无改善者1例占6.7％.结论 球内异物后行内眼手术,是感染性眼内炎最主要的致病因素,早期诊断、早期检测病原体确定敏感药物,早期实施玻璃体切割术联合玻璃体腔注药术,是治疗的关键,提高医务人员对内眼手术后发生感染性眼内炎重要性的认识、对内眼手术患者严密观察病情变化、强化眼部消毒处理、严格无菌操作,能防范感染性眼内炎的发生.

Risk factors and preventive measures for infectious endophthalmitis after intraocular surgery

OBJECTIVE To explore the risk factors and preventive measures for endophthalmitis after intraocular surgery.METHODS The patients with endophthalmitis after intraocular surgery from Jan.2006 to Dec.2010 were collected and analyzed retrospectively.RESULTS Among 3887 patients who received intraocular surgery,infectious endophthalmitis occurred in 15 cases with the infection rate of 0.4%,among which the patients undergoing intraocular foreign body removal surgery were the highest(12 cases,accounting for 80.0%).There was also 1 case of postvitrectomy(6.7%),1 case of teabeculectomy(6.7%),and 1 case of endoophthalmitis caused by cataract surgery(6.7%).The visual acuity of 12 cases(80.0%) was improved to varying degrees after active anti-infective ball injection and surgical treatment.The visual acuity was not improved in 1 case,accounting for 6.7%.CONCLUSION The intraocular surgery preformed after foreign bodies is the main reason for infectious endoophthalmitis.Early diagnosis,early detection of pathogens to determine the susceptible drug and the early implementation of the vitrectomy combined with vitreouscavity injection are the keys for the treatment.To improve the awareness of the medical staff about the importance of the endophthalmitis after intraocular surgery,close observation of disease status of patients with intraocular surgery,enhancement of eye disinfection and strict aseptic operation can prevent infectious endophthalmitis.