目的:探讨23 G玻璃体切割术治疗白内障术后迟发型眼内炎的临床疗效.方法:回顾性分析2010-01/2016-01在武汉大学人民医院,接受23 G玻璃体切割术治疗的白内障术后迟发型眼内炎患者15例15眼,距离白内障手术的平均时间为5.13±2.41mo.患者术前均有不同程度眼内炎症状及体征,术后行眼前段、眼底及最佳矫正视力检查.结果:致病菌培养结果显示,致病菌培养阳性9眼(60％),由厌氧菌感染引起4眼(44％),由真菌感染引起3眼(33％),由需氧菌感染引起2眼(22％).术后的平均随访时间为12 mo.经23 G玻璃体切割术治疗后,与治疗前视力比较,差异有统计学意义(P=0.009),经23G玻璃体切割术联合人工晶状体取出、硅油填充及晶状体囊切割治疗后炎症未得到有效控制,行眼内容物剜除术1眼(7％).结论:23 G玻璃体切割术治疗白内障术后迟发型眼内炎安全、有效,联合人工晶状体取出及晶状体囊切割可能有效预防其复发.%AIM: To discuss the clinical effect of 23-gauge pas plana vitrectomy ( PPV) for delay-onset endophthalmitis following cataract surgery.? METHODS: This retrospective chart review study included patients with delay-onset endophthalmitis that was present 6wk or more after cataract surgery, who underwent 23-gauge PPV from January 2010 to January 2016 at Renmin Hospital of Wuhan University. The diagnosis was made according to clinical symptoms and signs. The postoperative follow - up results were recorded, including anterior segment examinations, fundus examinations, and best-corrected visual acuity.?RESULTS:Totally 15 patients (15 eyes) were included. The average time between cataract surgery and their eye symptoms of endophthalmitis was 5. 13 ± 2. 41mo. The culture isolates revealed that 9 eyes ( 60％) were cultured positive, anaerobes in 4 eyes (44％), fungal infections in 3 eyes ( 33％) , aerobes in 2 eyes ( 22％) . The mean follow-up period was 12mo. The final visual outcomes were as follows:11 eyes ( 73％) achieved a better vision with PPV; 3 eyes ( 20％) achieved a better vision with PPV, total capsulectomy ( TC ) and IOL removal; 1 eye ( 7％) with PPV, silicone oil tamponade, total capsulectomy ( TC ) and IOL removal was enucleated because of uncontrolled inflammation.?CONCLUSION: The 23-gauge PPV is safe and effective for the management of delay - onset endophthalmitis following cataract surgery. Recurrence rate might be decreased with total capsulectomy and IOL removal.
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