超声乳化白内障吸除术后眼内炎的临床探析

Clinical analysis of phacoemulsification postoperative endophthalmitis

目的:探讨超声乳化白内障吸除术后发生感染性眼内炎的有关因素及其预防方法。方法:2010年1月-2014年1月收治超声乳化白内障吸除人工晶状体植入术患者63 372例,对临床资料进行回顾性分析。结果:感染性眼内炎14只眼,感染率0.02%,发生于2010年前11只眼(78.6%),术中晶状体后囊膜破裂5只眼(35.7%);11只眼行房水及玻璃体病原学检查的结果显示,7只眼培养为阳性,表皮葡萄球菌、铜绿假单胞菌和芽孢杆菌、真菌的眼数分别为3、1、2。治疗后5只眼的视力>0.2,只手动或者光感,摘除眼球和眼球萎缩的眼数各为2。结论:实施超声乳化白内障吸除,患者术后发生感染性眼内炎的概率0.02%,表皮葡萄球菌是主要致病因素。晶状体后囊膜破裂则是诱发眼内感染的重要危险因素之一。但是严格按常规行术前、术中及术后的操作,可有效减少术后感染性眼内炎的发生。

Objective:To explore the related factors and prevention methods of phacoemulsification postoperative infectious endophthalmitis.Methods:63 372 patients with phacoemulsification and intraocular lens implantation were selected from January2010 to January 2014.The clinical data were retrospectively analyzed.Results:14 eyes were infectious endophthalmitis,and the infection rate was 0.02%;11 eyes(78.6%) occurred before 2010;5 eyes(35.7%) were postoperative microtek shaped body posterior capsular rupture.The aqueous and vitreous pathogen examination results of 11 eyes showed that 7 eyes culture was positive;the eye number of staphylococcus epidermidis, pseudomonas aeruginosa, bacillus and fungi was 3,1,2.After treatment;the vision of 5eyes were more than 0.2,manual or light,enucleation and atrophy of eyeball eye number was 2 in each.Conclusion:Implementing phacoemulsification,the probability of the occurrence of infectious endophthalmitis after operation is 0.02%;staphylococcus epidermidis is the main pathogenic factors.The study find that microtek shaped body posterior capsular rupture is one of important risk factors to induce intraocular infection.According to strict routine preoperative,intraoperative and postoperative operation can effectively reduce the occurrence of postoperative infectious endophthalmitis situation.