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目的探讨人工晶状体(IOL)植入术后细菌性眼内炎治疗的方法。设计回颐性病例系列。研究对象宣武医院2002-2008年治疗的IOL植入术后眼内炎患者15例15眼。方法所有患者先采用玻璃体腔注射抗生素治疗,如果炎症不能被控制注药后24小时行玻璃体切除术。主要指标眼内感染情况,视力,病原学检查结果。结果13例(86.6%)在术后72小时后发病。均进行了前房水或玻璃体标本的病原学检查,6例培养阳性,4例为表皮葡萄球菌。经玻璃体注入万古霉素等治疗,12例(80%)炎症被控制,其中10例视力恢复到0.1以上。3例炎症不能控制进行了玻璃体切除术。结论表皮葡萄球菌可能是亚急性IOL术后眼内炎的主要原因,及时的玻璃体腔注射抗生素治疗能控制大部分IOL植入术后的眼内炎。
Objective To investigate the treatment of bacterial endophthalmitis after intraocular lens (IOL) implantation. Design back to the sexuality cases series. The study included 15 patients (15 eyes) with endophthalmitis after IOL implantation in Xuanwu Hospital from 2002-2008. Methods All patients were treated with vitreous cavity injection of antibiotics, and if the inflammation could not be controlled, vitrectomy was performed 24 hours after injection. The main indicators of intraocular infection, visual acuity, etiological examination results. Results Thirteen (86.6%) patients developed after 72 hours. All of the anterior chamber water or vitreous specimens etiological examination, 6 cases of culture positive, 4 cases of Staphylococcus epidermidis. After vitreous injection of vancomycin and other treatment, 12 cases (80%) of the inflammation was controlled, of which 10 cases of visual acuity recovered to 0.1 or more. 3 cases of inflammation can not control the vitrectomy. Conclusion Staphylococcus epidermidis may be the main cause of endophthalmitis after subacute IOL surgery. Timely intravitreal antibiotic treatment can control most endophthalmitis after IOL implantation.