摘要
目的观察巩膜扣带手术后发生硅胶带感染患者的临床表现、治疗效果和细菌培养结果。方法因硅胶带感染行硅胶带取出手术的7例患者7只眼纳入研究。所有患者既往均因孔源性视网膜脱离而行巩膜扣带手术。其中,男性4例4只眼,女性3例3只眼;年龄12~69岁,平均年龄42.7岁。右眼4只,左眼3只。既往合并全身病史者6例。发现硅胶带感染距上次手术时间2周~10年,平均47.5个月。所有患者均行视力、裂隙灯显微镜、间接检眼镜检查,部分患者行外眼及眼底照相检查。考虑感染后均行硅胶带取出手术,手术后取出的硅胶带送细菌培养。硅胶带取出手术治疗后随访2周~8个月,平均随访时间3.2个月。观察有无感染复发及视网膜脱离发生。结果7只眼中,硅胶带暴露3只眼,无硅胶带暴露4只眼。有硅胶带暴露的3只眼中,明显眼部红肿疼痛、球结膜充血明显、结膜囊可见黄白色分泌物2只眼;眼部分泌物增多伴异物感、结膜囊内较多黄白色分泌物1只眼。无硅胶带暴露的4只眼中,眼部红肿疼痛、眼部分泌物增多、球结膜充血水肿、结膜囊有黄白色分泌物2只眼;反复球结膜下出血伴复视,球结膜下血肿1只眼;视力下降伴眼分泌物增多、球结膜下脓性分泌物、视网膜全脱离1只眼。所有患者均无眼内炎症反应。硅胶带取出手术后,所有患眼感染均得到控制,在随访期内感染均无复发,视网膜未发生脱离。细菌培养结果显示,所有硅胶带细菌培养均呈阳性。分别为金黄色葡萄球菌、表皮葡萄球菌和猪红斑丹毒丝菌、革兰氏阳性棒状杆菌、黄曲霉菌、玫瑰库克菌属、口腔链球菌、麦氏棒杆菌。结论巩膜扣带手术后硅胶带感染临床表现及分离出的致病微生物多种多样,行硅胶带取出手术可控制感染。
Objective To observe the clinical manifestations, therapeutic efficacy and results of bacterial culture of seven patients of scleral buckle (SB) infection after scleral bulking surgery. Methods Seven patients (seven eyes) underwent SB removal for SB infections were enrolled in this study. The patients included four males (four eyes) and three females (three eyes). The patients aged from 12 to 69 years, with a mean age of 42.7 years. There were four right eyes and three left eyes. The duration (interval between primary surgery and SB removal) ranged from two weeks to ten years, with a mean of 47.5 months. Six patients were concurrent with systemic disease. All the patients were examined for visual acuity, slit lamp microscope and indirect ophthalmoscope examination. Some patients also received external eye examination and fundus photography. Whether SB exposure or not and the clinical manifestations were observed. SB removal was performed in all the patients and the SB were sent to the laboratory for bacterial culture. The follow-up time ranged from two weeks to eight months, with a mean of 3.2 months. Whether infections recurrence and retinal detachment or not were observed. Results SB exposure was in three eyes. Obvious ocular pain and swelling, conjunctival hyperemia and visible yellow-white discharge in the conjunctival sac were presented in two eyes; irritation and discharge were in one eye. No SB exposure was in four eyes. Ocular pain and swelling, conjunctival hyperemia and visible yellow-white discharge in the conjunctival sac were presented in two eyes. Repeated subconjunctival hemorrhage and diplopia were presented in one eye. Visual acuity decline, conjunctival sac discharge and total retinal detachment were in one eye. All patients had no intraocular inflammation. The infection was controlled after SB removal and the retina was attached during the follow-up. The bacterial culture were all positive, which included Staphylococcus aureus, Staphylcoccus epidermidis and Erysipelothrix rh
出处
《中华眼底病杂志》
CAS
CSCD
北大核心
2013年第2期162-165,共4页
Chinese Journal of Ocular Fundus Diseases
关键词
巩膜扣带术
假体和植入物
副作用
眼感染
细菌性
Scleral bulking surgery
Prostheses and implants/adverse effects
Eye infections,bacterial