2015-2020年埃及三角洲人群白内障术后眼内炎早期玻璃体切除术疗效分析

A. Tabl, M. Masoud, G. Abdelhalim, M. Tabl
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摘要

目的评价早期平坦部玻璃体切除术(PPV)治疗白内障术后急性发作性眼内炎的疗效。研究设计回顾性观察研究。患者和方法我们收集了11名患者的数据,这些患者在2015年1月至2020年12月白内障手术后6周内被诊断为急性感染性眼内炎,并接受了早期23-G PPV,并随访了3个月。我们分析了可能影响预后和最终视觉结果的因素。结果患者平均年龄58±5岁,以男性为主(72.7%),平均眼轴长度24.76±1.58mm,基线最佳矫正视力为2.3 logMAR,第3个月提高至1.2 logMAR(P<0.001),63.6%的患者采用混合气/液眼内压塞。大约一半的病例有阳性培养物(54.5%),最常见的病原体是金黄色葡萄球菌(66.7%)。36.4%的患者报告视网膜脱离。与最终最佳矫正视力相关的术前因素是玻璃体后脱离和眼内压塞。结论白内障手术后急性发作性眼内炎的早期PPV有助于改善最终视觉效果,保持眼球的结构和功能完整性,从而预防可能影响患者生活质量的晚期并发症。影响最终视力结果的因素是眼内压塞和玻璃体后脱离。
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Outcomes of early vitrectomy for endophthalmitis after cataract surgery in delta population, Egypt, 2015–2020
Purpose To evaluate the outcomes of early pars-plana vitrectomy (PPV) in the management of acute onset endophthalmitis after cataract surgery. Study design Retrospective observational study. Patients and methods We collected data from 11 patients who were diagnosed as acute infectious endophthalmitis within 6 weeks after cataract surgery, from January 2015 to December 2020 and had undergone early 23-G PPV and were followed up for 3 months. We analyzed factors that may affect prognosis and final visual outcomes. Results The mean age was 58±5 years, there was male predominance (72.7%). The mean axial length was 24.76±1.58 mm. The baseline best-corrected visual acuity was 2.3 logMAR and was improved to 1.2 logMAR at the third month (P<0.001). Mixed air/fluid intraocular tamponade was used in 63.6% of patients. About half of the cases had positive cultures (54.5%), and the most frequent organism was Staphylococcus aureus (66.7%). Retinal detachment was reported in 36.4% of patients. The preoperative factors correlated with final best-corrected visual acuity were posterior vitreous detachment and intraocular tamponade. Conclusions Early PPV for acute-onset endophthalmitis after cataract surgery aided in improving final visual outcome and preserving structural and functional integrity of the globe, thus preventing late complications that could affect patients’ quality of life. Factors that influence the final visual outcome were intraocular tamponade and posterior vitreous detachment.
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