玻璃体内注药术后眼内炎的危险因素及预防

Risk factors and prevention of endophthalmitis after intravitreal injection

近年来玻璃体内药物注射的发展非常迅速，应用范围不断扩大，尤其是玻璃体内注射抗血管内皮生长因子（vascularendothelialgrowthfactor，VEGF）制剂已成为眼科最常用的治疗方法之一。因此更有必要认真审视其并发症，尤其是眼内炎这一玻璃体内注射最严重的并发症。研究显示玻璃体内注射抗VEGF制剂后眼内炎发生率约0．02％～0．09％。危险因素包括注射前危险因素（活动性外眼感染、按压眼睑、较粗注射针头、青光眼、糖尿病等系统性疾病），注射中危险因素（飞沫传播、无菌操作不严格）和注射后危险因素（多次注射）等。围手术期使用抗生素预防的效果尚无定论。

Intravitreal injections have been developed and applied rapidly in recent years, especially the intravitreal injection of vascular endothelial growth factor （VEGF）, which has become one of the most common treatments in ophthalmology. This underscores the need that the complications of such treatment ought to merit full attention. Endophthalmitis is the most serious complication of intravitreal injections. Stud- ies showed that the occurrence rate for endophthalmitis after the injection of VEGF is in the range of 0.02% ~0.09%, with risk factors involving those before the injection, such as active external ocular infection, pressing of the eyelid, thick needles, glaucoma, diabetes and other systemic diseases ; those during the in- jection, such as droplet transmission and flawed aseptic technique; and those after the injection, such as multi-injections. The effects of antibiotic treatments during perioperative period are not yet clear.