聚维酮碘对预防白内障术后眼内炎的疗效观察

Effect of povidone-iodine on prevention of postoperative endophthalmitis in patients with cataract

目的观察结膜囊使用聚维酮碘消毒对预防白内障术后眼内炎的疗效及其安全性。方法回顾分析2013年9月至2015年8月行白内障超声乳化吸除+人工晶体植入术的患者。其中,术前结膜囊未使用聚维酮碘的白内障患者692例共947只眼,术前结膜囊使用5%聚维酮碘的白内障患者587例共807只眼,比较两组眼内炎的发病率、自觉症状以及角膜荧光染色的情况。结果未使用聚维酮碘组有6例患者发生眼内炎,5%聚维酮碘组无患者发生眼内炎,两组对比差异有统计学意义(χ2=5.131,P=0.034)。5%聚维酮碘组在使用聚维酮碘后出现局部刺激症状295例,但术后两组自觉症状发生率(χ2=2.123,P=0.145)以及术后第1天(Z=1.363,P=0.173)和第1周(Z=0.569,P=0.570)角膜荧光染色得分比较差异无统计学意义。结论白内障术前应用5%聚维酮碘消毒结膜囊能有效、安全地降低术后感染性眼内炎的发生。

Objective To investigate the efficacy and safety of 5% povidone‐iodine on prevention of postoperative endophthalmi‐tis in patients with cataract .Methods A retrospective analysis was performed on patients who underwent cataract surgeries be‐tween September 2013 to August 2015 in the hospital .Among the patients ,5% povidone‐iodine was used on 807 eyes of 587 cases in the conjunctiva sac before surgery ,while povidone‐iodine was not used on 947 eyes of 692 cases .The incidence of postoperative endophthalmitis ,patients′conscious symptoms and corneal fluorescent staining were compared between the two groups .Results Six cases and none patients suffered postoperative endophthalmitis in non povidone‐iodine group and povidone‐iodine group respec‐tively ,the difference between the two groups was statistically significant （χ2 =5 .131 ,P=0 .034） .A total of 295 patients had com‐plained of ocular irritation after using povidone‐iodine immediately .But the incidence of patients′conscious symptoms（χ2 =2 .123 , P=0 .145） and the score of corneal fluorescent staining one day after the surgery （Z=1 .363 ,P=0 .173） and one week after the surgery （Z=0 .569 ,P=0 .570） were not significantly different between the two groups .Conclusion 5% povidone‐iodine is effec‐tive and safe in reducing the incidence of postoperative endophthalmitis in patients with cataract .