前房内注射头孢呋辛预防超声乳化术后眼内炎的临床观察

Evaluation of intracameral cefuroxime injection for endophthalmitis prophylaxis following phacoemulsification

目的:探讨前房内注射头孢呋辛对预防超声乳化术后眼内炎的临床效果。方法:回顾性研究2015-01/2018-06在我院接受超声乳化白内障手术患者3112例4210眼的临床资料,以2015-01/2017-04诊治的1810例2250眼患者为对照组,以2017-05/2018-07诊治的1302例1960眼患者为试验组。两组患者均行超声乳化联合Ⅰ期人工晶状体植入术。试验组术毕前房内注射头孢呋辛1mg/0. 1mL,对照组前房内未注射抗生素。术后随访1～8mo,观察两组患者的视力和感染性眼内炎发生情况。结果:对照组术后6mo内最佳矫正视力>1. 0者1 344眼,0. 5～0. 9者696眼,0. 1～0. 4者151眼,<0. 1者59眼;而试验组术后6mo内最佳矫正视力>1. 0者1 136眼,0. 5～0. 9者624眼,0. 1～0. 4者146眼,<0. 1者54眼。试验组术后6mo内未见眼内炎发生,对照组3例3眼(0. 13%)术后发生眼内炎,两组比较差异无统计学意义(P=0. 15)。对照组3例3眼眼内炎患者经全身联合眼局部治疗后治愈。试验组前房注药后均未见角膜内皮失代偿、视网膜毒性等药物相关毒性和过敏反应。结论:前房内注射头孢呋辛能有效预防超声乳化术后眼内炎的发生,安全有效。

AIM： To investigate the clinical effect of intracameral cefuroxime injection on prevention of endophthalmitis following phacoemulsification. METHODS： This was a retrospective clinical study. The clinical records were reviewed for 3112 patients（4210 eyes）with cataract phacoemulsification in our hospital from January 2015 to June 2018; 1810 patients（2250 eyes）without intracameral cefuroxime injection were treated as control group from January 2015 to April 2017; 1302 cases（1960 eyes）with intracameral cefuroxime injection were treated as experimental group from May 2017 to July 2018. Patients in both groups were treated with phacoemulsification and intraocular lens implantation. The follow-up period was 1-8mo and the visual acuity and the infectious endophthalmitis were observed and compared. RESULTS：There were 1 344 eyes with best corrected visual acuity 〉1.0, 696 eyes with 0.5-0.9, 151 eyes with 0.1-0.4, 59 eyes with 〈0.1 in control group within 6mo after operation; those in experimental group were 1 136 eyes, 624 eyes, 146 eyes, 54 eyes. No postoperative endophthalmitis case occurred in experimental group. Three postoperative endophthalmitis cases（3 eyes）occurred in control group, 0.13%（3/2250）. There was no significant difference between the two groups（P=0.15）. All the cases with endophthalmitis were cured. No sever complication was reported with intracameral cefuroxime, corneal endothelium decompensation, retinal toxicity. CONCLUSION： Intracameral cefuroxime injection is safe and effective in prevention of endophthalmitis following phacoemulsification.