白内障摘除手术后感染预防中值得关注的问题

Problems deserving attention in preventing infection in cataract surgery

感染性眼内炎是白内障摘除手术最严重的并发症之一,如何减少白内障摘除术后感染性眼内炎的发生备受关注.目前临床常采用聚维酮碘结膜囊灌洗、手术末前房注射抗生素等方法预防术后感染.聚维酮碘的应用浓度、方式以及作用时间国内外尚无统一意见,用于前房注射的抗生素也有很多选择,各种方法均存在不良反应.无菌手术贴膜在术中隔离菌群、预防感染方面发挥了重要的作用,但效果尚无法确定.本文就白内障摘除术后预防感染中值得关注的问题进行分析讨论,以期为开展多中心、大样本研究提供参考,制定相应的操作规范.

Endophthalmitis is one of the most serious complications of cataract surgery. The surgeons try to reduce the incidence of endophthalmitis. In order to prevent postoperative infection, irrigation of the conjunctival sac with povidone iodine and injection of antibiotics into the anterior chamber before the end of the surgery are used. Although there are a lot of reports about the concentration, mode and duration of povidone iodine application, there is no consensus. There are many options for antibiotics, including cefuroxime, vancomycin and moxifloxacin. Side effects of using povidone iodine and antibiotics have also been reported. An aseptic surgical mask plays an important role in isolating bacteria for prevention of infection. However, whether it could completely isolate bacteria can not be determined. In this article, several issues concerning the prevention of infection after cataract surgery are discussed. We hope that there will be a multi-center and large-sample research to assist in drawing up operating specifications.