摘要
目的:探讨白内障术后非感染性眼内炎发生时间、临床表现、危险因素、治疗过程及预后情况。方法:回顾性研究。收集2020年10月13日至2020年11月19日期间在陆军特色医学中心眼科纳入白内障超声乳化联合人工晶体植入术患者1004例(1420眼),将发生非感染性炎症与未发生炎症者分为炎症组与非炎症组,分析术后发生非感染性眼内炎的患者的围手术期所用药物、器械使用及手术操作等环节,并查找其发病时间、症状、体征、治疗方式以及治疗前后的最佳矫正视力(BCVA)评分等。采用t检验和重复测量方差分析进行数据处理。结果:发生非感染性眼内炎16例(21眼),其中男5例(7眼),女11例(14眼),年龄54~83(68.6±9.5)岁。围手术期所有药品、器械无违规,所有消毒用品消毒指标均合格,手术操作过程规范,无并发症发生。术中均使用同一品牌型号的疏水性丙烯酸酯人工晶状体。发病时间为术后(23.3±9.7)d。结膜呈现混合性充血,角膜透明,前房闪辉(+~+++),前房细胞(++~+++)。部分患者前房内有纤维素性渗出,B超显示玻璃体不同程度的混浊。所有患者前房水及玻璃体病原微生物检测均为阴性。炎症组与非炎症组术前内皮细胞计数、眼压均为正常,角膜曲率、眼轴长度差异均无统计学意义。炎症组前房深度明显小于非炎症组,差异有统计学意义(t=-2.55,P=0.010)。结论:本研究中白内障术后非感染性眼内炎高度怀疑与人工晶状体有关,经过积极治疗后,炎症均得到控制并消退。
Objective:To investigate the time of occurrence,clinical manifestations,rick factors,treatment process and prognosis of noninfectious endophthalmitis after cataract surger.Methods:A total of 1004 patients(1420 eyes)who underwent phacoemulsification combined with intraocular lens implantation were enrolled in this retrospective study,from October 13 to November 19,2020 in Department of Ophthalmology,Army Medical Center of PLA.The perioperative medications,surgical of instrument,surgical procedures and postoperativ procedures were analyzed in in patients with postoperative non-infectious endophthalmitis.The time of onset,symptoms,signs,best-corrected visual acuity(BCVA)scores before and after treatment of non-infectious endophthalmitis were observed.The patients with non-infectious endophthalmitis and those without endophthalmitis were divided into inflammatory group and non inflammatory group,respectively.The data were analyzed by t-test and repeated measurement analysis of variance.Results:Sixteen cases(21 eyes)of non-infectious endophthalmitis were enrolled,including 5 males(7 eyes)and 11 female(14 eyes),with an average age of 68.6±9.5(54-83)years.During the perioperative period,all drugs and instruments are free of violation.All disinfection products were qualified.The operation process was standardized and no complications occurred during the surgry.The same brand and model of hydrophobic acrylate intraocular lens were used in all patients with non-infectious endophthalmitis.The average onset time was 23.3±9.7 days after surgery.Conjunctiva showed mixed hyperemia.The cornea was transparent.The anterior chamber glitter was(+-+++).The anterior chamber cells was(++-+++).There was fibrinous exudation in the anterior chamber in some patients.B-mode ultrasound showed varying degrees of vitreous opacity.The detection of pathogenic microorganisms in aqueous humor and vitreous was negative in all patients.Preoperative endothelial cell count and intraocular pressure were normal in both groups.There were no statistically difference in corneal curvature and axial length between inflammatory and non-inflammatory groups.The depth of anterior chamber in inflammatory group was significantly lower than that in non inflammatory group(t=-2.55,P=0.010).Conclusion:In this study,non-infectious endophthalmitis after cataract surgery was highly suspected to be related to the intraocular lens.After active treatment,the inflammation was controlled and resolved.
作者
喻娟
邓小丽
傅小毅
李锐锋
叶剑
孙敏
Juan Yu;Xiaoli Deng;Xiaoyi Fu;Ruifeng Li;Jian Ye;Min Sun(Department of Ophthalmology,Amy Medical Center of PLA,Chongqing 400038,China)
出处
《中华眼视光学与视觉科学杂志》
CAS
CSCD
2022年第8期622-627,共6页
Chinese Journal Of Optometry Ophthalmology And Visual Science
基金
国家自然科学基金面上项目(82070945)。
关键词
白内障
人工晶状体
非感染性眼内炎
cataract
intraocular lens
non-infectious endophthalmitis
作者简介
第一作者:喻娟(ORCID:0000-0002-1777-0517),,Email:23920747@q.com;通信作者:孙敏(ORCID:0000-0001-9431-4032),Email:minmins@126.com。
