玻璃体切除术后的化脓性眼内炎

ENDOPHTHALMITIS AFTER PARS PLANA VITRECTOMY

目的：总结玻璃体手术后化脓性眼内炎的发生率、临床特点、治疗及预后。方法：收集１９８７～１９９８年因各种原因引起玻璃体混浊、复杂性视网膜脱离而进行玻璃体手术（不包括穿孔性眼外伤或眼内炎病例），术后经过临床或培养而证实为化脓性眼内炎病例。结果：符合标准者共４６１０例，其中３例术后发生化脓性眼内炎，发生率为０６５‰。１例培养出葡萄球菌和霍米奇肠杆菌。分别在术后第６、８和１０天控制炎症。最终视力２例保留光感，１例００２，２例视网膜脱离未能复位，眼球萎缩。结论：玻璃体切除术后眼内炎发生罕见，但视力预后差，必须高度重视。

Objective: To describe the incidence, clinical characteristics, treatment and prognosis of postvitrectomy endophthalmitis. Methods: Patients undergoing pars plana vitretomy (PPV) for opaque vitreous and complex retinal detachment during 1987 to 1998 were collected. Patients undergoing PPV for recent trauma or endophthalmitis were excluded. Patients suffered from clinical or culture proven postvitrectomy endophthalmitis were selected. Results: 4 610 cases conformed to the criterion (consecutive cases) and postvitrectomy endophthalmitis happened to three patients. The incidence was 0 65‰ (3/4 610). Endophthamitis were controlled within 6 days, 8 days and 10 days. Final visual acuities were light perception (2 eyes) and 0 02 (1 eyes). The retina were unsuccessful to attach and the eye balls tended to atrophy in two eyes. Conclusion: Endophthalmitis after pars plana vitrectomy was rare. But it had a bad prognosis, we must pay high attention to it.