外伤性眼内炎玻璃体手术的预后因素分析

Analysis of prognostic correlative factors in vitrectomy eyes of traumatic endophthalmitis

目的:探讨外伤性眼内炎玻璃体切除术治疗视力预后的相关因素。方法:回顾性分析62例62眼行玻璃体切除术治疗的外伤性眼内炎患者的临床资料,即对患眼的自然因素(性别、年龄、眼别、视力、眼压、眼内异物、致伤情况、外伤性白内障、血管炎性改变、视网膜脱离、病原学检查/培养结果)、围手术因素(术前玻璃体注药史、手术方式、术中眼内充填气体/硅油、术中及术后并发症)等因素与随访0.5a后视力及患眼预后情况进行多因素分析。结果:62眼预后:矫正视力>0.02者53眼(85%),其中13眼矫正视力>0.3者13眼(21%),眼球摘除者2眼(3%)。多元分析结果显示:患眼自然因素中视网膜血管炎性改变、视网膜脱离的发生对视力预后影响具有显著性意义;围手术因素中,眼内炎症加重,手术复杂程度增加,手术失败的危险性亦增加,术后并发症的发生亦对不良视力预后的相关性增加。结论:合并视网膜脱离、血管炎性改变,手术复杂程度及术后并发症发生等因素是与外伤性眼内炎患者视力远期预后密切相关的因素。对于诊断明确的外伤性眼内炎应尽早行玻璃体手术。

AIM：To evaluate the correlative factors of visual acuity（VA） among patients with vitrectomy of traumatic endophthalmitis.·METHODS：A retrospective analysis on clinical data was performed on 62 patients（62 eyes） with vitrectomy for traumatic endophthalmitis. Recorded data bases were sex,age,VA intraocular foreign body,tramatic cataract,retinal detachment（RD） ,basic surgical maneuvers,complications after surgery and so on. The average follow-up was 6 months.·RESULTS：Final VA of 53 eyes（85%） were better than 0.02,in which 13 eyes（21%） were better than 0.3. Two eyes（3%） had enucleation. Multiple-variable analysis showed that the factors significantly affecting prognosis of vitrectomied eyes of traumatic endophthalmit-is were RD before surgery,retinits,severe endophthalmitis,complexity of surgical maneuvers and complications after surgery.·CONCLUSION：RD before surgery,retinits,complexity of surgery and post vitrectomy complications are elosely related to the final vision in vitrectomy eyes of traumatic endophthalmitis. Early vitrectomy is an effective method for traumatic endophthalmitis.