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创伤后眼内炎:18年病例系列研究

Li, X., Zarbin, M.A., Langer, P.D., Bhagat, N

期刊名称:Retina

卷期:2018年第38卷第1期

关键词:
病例 创伤

摘要

摘要:目的:旨在描述眼球开放性损伤后诊断为眼内炎的患者的人口统计学,特征,治疗和视力预后。方法:回顾性队列分析1997 - 2015年间在新泽西州纽瓦克大学医院诊断为眼内炎的所有患者。结果:确定了26只眼(均为男性患者;平均年龄:37±15岁)。16只眼(62%)培养阳性,葡萄球菌(7只眼,44%)是最常见的致病菌。有12只眼(46%)出现开放性眼损伤并发眼内炎; 14只眼(54%)在开放性眼球修复(OGR; 排除198天异常病例)后平均14天发生眼内炎。所有眼都进行全身和玻璃体内抗生素治疗。眼内异物(P <0.05)和延迟性原发性OGRP <0.03)明显较OGR后眼内炎更常见。 OGR后组有4只眼(29%)出现角膜伤口渗漏。没有光感视力的4只眼(15%)被摘除。 25只有最佳矫正视力记录的患者中有10只(40%)的最终矫正视力≥20/ 200;最终的最佳矫正视力从无光感到20/20。结论:眼内异物的存在和延迟表现更常见与眼内炎并发。OGR之后29%的眼内炎眼有伤口渗漏。 40%的病例最终的最佳矫正视力≥20/ 200

PURPOSE:To describe the demographics, characteristics, management, and visual outcomes of eyes diagnosed with endophthalmitis after open globe injury.METHODS:Retrospective cohort analysis of all patients diagnosed with endophthalmitis after open globe injury from 1997 to 2015 at University Hospital, Newark, NJ.RESULTS:Twenty-six eyes were identified (all male patients; mean age: 37 ± 15 years). Cultures were positive in 16 eyes (62%), with Staphylococcus species (7 eyes, 44%) being the most common organism. Twelve eyes (46%) presented with open globe injury and concurrent endophthalmitis; 14 eyes (54%) developed endophthalmitis a mean of 14 days after open globe repair (OGR; 1 outlier of 98 days excluded). All eyes were managed with systemic and intravitreal antibiotics. The presence of intraocular foreign body (P < 0.05) and delayed primary OGR (P < 0.03) were significantly more common with concurrent versus post-OGR endophthalmitis. Four (29%) eyes in the post-OGR endophthalmitis group had corneal wound leak after OGR. Four (15%) eyes with no light perception vision were enucleated. Ten (40%) of 25 eyes with documented best-corrected visual acuity had final best-corrected visual acuity 20/200; final best-corrected visual acuity ranged from no light perception to 20/20.CONCLUSION:The presence of intraocular foreign body and delayed presentation were significantly more common with concurrent endophthalmitis. Twenty-nine percent of eyes that presented with endophthalmitis after OGR had a wound leak. Final best-corrected visual acuity 20/200 was achieved in 40% of cases.


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