玻璃体切割术治疗外伤性感染性眼内炎的临床分析

Clinical analyses on therapeutic effect of vitrectomy for traumatic endophthalmitis

目的 评估玻璃体切割术对外伤性感染性眼内炎的治疗效果。方法 对 1 7例 (1 7眼 )眼内炎患者行玻璃体切割手术(大多数患者同时晶体切除 ) ,术中结合庆大霉素玻璃体腔灌注。结果 2例因视网膜坏死术中即行眼内容物剜出术 ,植入义眼胎。其余 1 5例随访 1周至 6月 ,视力在 0 0 4～ 0 0 6 8例 ,0 1～ 0 2 5例 ,0 5～ 1 0 2例。结论 玻璃体切割术能迅速有效地治疗眼内炎 ,促进病情恢复 ,避免视网膜脓疡、玻璃体机化、牵引性视网膜脱离 ,甚至严重的全眼球炎的发生。玻璃体切割治疗外伤性感染性眼内炎是最佳治疗方案 ,及时诊断 ,及时治疗是治疗的关键 。

Objective To evaluate the therapeutic effect of vitrectomy for traumatic and infective endophthalmitis. Methods Vitrectomies were operated on 17 eyes of 17 patients with this endophthalmitis, meanwhile gentamicin was affused into vitreous cavity, and lensectomies were performed on most eyes. Results Two eyes were eviscerated and inserted artificial eye embryos due to retinal necrosis in operation. The visual acuities of other patients from 1 week to 6 months after operation were 0.04～0.06 in 8 eyes, 0.1～0.2 in 5 eyes, and 0.5～1.0 in 2 eyes. Conclusion Vitrectomy can rapidly and effectively cure traumatic and infective endophthalmitis, improve patients' condition and avoid retinal purulency, vitreous organization, tractional detachment of retina and even serious panophthalmitis. Vitrectomy is the best therapeutic approach for traumatic and infective endophthalmitis. Prompt diagnoses and treatment are key point and interrelated with patients' prognosis.