摘要
目的:观察玻璃体切除术治疗外伤性化脓性眼内炎的效果。方法:对16例16眼外伤性化脓性眼内炎行玻璃体切除术联合应用抗生素,术中根据眼内情况行异物取出,眼内光凝,外冷凝,气液交换后C3F8注入或硅油填充,部分联合巩膜外环扎,术前常规玻璃体标本实验室检验,术后根据药敏调整用药。结果:16眼化脓性眼内炎炎症全部得到控制,合并异物者均顺利取出,实验室检验G+球菌7例,G-杆菌2例,阳性率56%,10例硅油填充者8例硅油取出视网膜复位良好,其中硅油填充期间视网膜增殖及裂孔发生补激光者4例,2例未取硅油视网膜增殖严重,裂孔形成,眼内注气吸收后发生视网膜脱离者3例,再手术硅油填充最终视网膜复位良好,随诊3～24mo,视力光感1例,无光感1例,0.02～0.08者3例,0.1～0.3者6例,0.4～0.6者3例,2例幼儿不配合但能追视物体,眼压≤8mmHg2例,其余眼压正常。结论:玻璃体切除术是治疗外伤性化脓性眼内炎的有效方法。眼内填充硅油要及时复查,及时处理。
AIM： To evaluate the effect of vitrectomy on traumatic purulent endophthalmitis.
METHODS： Sixteen cases with endopthalmitis were treated vitrectomy combined with antibiotics. We performed routine vitrectomy with foreign body resection, coagulation, condensation, gas-fluid exchange, C3F8 or silicone oil tamponade and sclera cerclage. Preoperative vitreous sample lab test and postoperative medicine adjusting according to drug sensive test were also performed.
RESULTS： Endothalmitis were controlled and foreign body were all took out in all the cases, with. G^＋ coccus infection in 7 cases and Gbacillus infection in 2 cases, the positive rate of lab test being 56%. Among the 10 cases with silicone oil tamponade, retinal become flat in 8 cases after silicone oil taken-out, including 4 cases with retina proliferation and retinal hole treated with laser coagulation. Severe retinal proliferation occurred and retinal holes were formed in the other 2 cases. The 3cases with gas tamponade had retinal detachment, and were treated with silicone oil tamponade. During the follow-up of 3-24mo, visual acuity of light perception was found in 1 cases. No light perception was found in 1 case. Three patients had visual acuities of 0.02-0.08, and 3 patients had those of 0.4-0.6. Visual acuity examination could not be performedin 2 children. 2 patients had intraocular pressure （IOP） lower than 2mmHg, and the others had normal IOP.
CONCLUSION： Vitrectomy is an effective treatment for purulent endophthalmitis.
出处
《国际眼科杂志》
CAS
2005年第6期1295-1297,共3页
International Eye Science
