摘要
目的分析白内障术后急性眼内炎的危险因素及玻璃体切除治疗白内障术后急性眼内炎的同时是否行人工晶状体取出对患者术后预后的影响。方法回顾性分析我院自2017年1月至2018年2月收治的白内障摘除+人工晶状体植入术后急性眼内炎患者33例(33只眼),根据玻璃体切除的同时是否行人工晶状体取出进行分组,分为人工晶状体取出组(IOL取出组),共14例(14只眼)和人工晶状体保留组(IOL保留组),共19例(19只眼),进行疗效及预后分析,主要分析患者高危因素、术后视力情况(最佳矫正视力)、角膜、前房、玻璃体情况。采用SPSS 22. 0统计学软件进行统计学数据处理及分析。结果 33例白内障术后急性眼内炎患者当中糖尿病患者5例,白内障术中后囊破裂患者6例。白内障术后急性眼内炎发作时间2～40 d,平均(16. 36±4. 25) d。该33例患者植入的人工晶状体中全部为疏水性材料。急性眼内炎发作时,结膜充血明显,角膜常有不同程度水肿,前房房水混浊,可有不同程度渗出、积脓,玻璃体不同程度混浊,眼底朦胧或完全窥不见。治疗方案为玻璃体切除术,其中4例合并硅油填充,术后3例患者视力下降,其余患者视力均得以保存,IOL取出组患者术后3 d角膜、前房情况恢复明显,IOL保留组患者术后3 d角膜仍有不同程度水肿,伴前房渗出物。结论白内障术后急性眼内炎的高发因素有合并糖尿病、后囊破裂、玻璃体溢出、手术时间过长。通过玻璃体切除术均可有效治疗、保存视力,对于严重急性眼内炎患者行玻璃体切除术的同时合并人工晶状体取出有利于患者的恢复。
Objective To study the risk factors of acute intraocular diseases after cataract surgery and the treatment of acute endophthalmitis after cataract surgery and observe the effect of intraocular lens removal on postoperative prognosis of patients. Methods A retrospective study was made to analyze 33 cases of acute endophthalmitis after cataract extraction and intraocular lens implantation in our hospital from January 2017 to February 2018. According to whether or not the intraocular lens was taken out, the intraocular lens was taken out and divided into the intraocular lens removal group (IOL removal group). A total of 14 cases of 14 eyes and an intraocular lens retention group (IOL retention group), a total of 19 cases of 19 eyes, the efficacy and prognostic analysis. The results were analyzed. The high risk factors, visual acuity (best corrected visual acuity), cornea, anterior chamber and vitreous body were mainly analyzed. SPSS 22 statistical software was used for statistical data processing and analysis. Results Among the 33 patients with acute endophthalmitis after cataract surgery, 5 cases had diabetes mellitus and 6 cases had posterior capsule rupture during cataract surgery. The onset time of acute endophthalmitis after cataract surgery was 2~40 days, with an average of 16.36 ± 4.25 days. All of the 33 implanted IOLs were hydrophobic materials. Acute endophthalmitis attacks, conjunctiva hyperemia obvious, cornea often have different degrees of edema, anterior chamber water cloudy, can have different degree of exudation, purulent, vitreous different degree of turbidity, the fundus hazy or completely peep. The treatment scheme was vitrectomy, of which 4 cases were filled with silicone oil, 3 patients with visual acuity decreased after operation, and the other patients' eyesight were preserved. The cornea and anterior chamber of the IOL extraction group recovered obviously on the 3 day after the operation. The cornea of the IOL retention group still had different degree of swelling and anterior chamber exuda
作者
董怡然
柯根杰
王林
董凯
顾永昊
顾起宏
Dong Yiran;Ke Genjie;Wang Lin;Dong Kai;Gu Yonghao;Gu Qihong(Department of Ophthalmology,the First Affiliated Hospital of University of Science and Technology of China, Hefei,Anhui 230000,China)
出处
《临床眼科杂志》
2018年第6期488-491,共4页
Journal of Clinical Ophthalmology
基金
安徽省自然科学基金青年项目(AHNSF1408085QH159)
国家自然科学基金青年项目(81400407)
关键词
白内障术后眼内炎
玻璃体切除
人工晶状体取出
Endophthalmitis after cataract surgery
Vitrectomy
Intraocular lens extraction
