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POSTTRAUMATIC ENDOPHTHALMITISCausative Organisms, Treatment, and Prevention

机译:创伤后眼内炎治疗微生物、治疗和预防

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Background:Posttraumatic endophthalmitis is a rare complication of penetrating eye injuries that results in blindness in potentially salvageable eyes.Methods:36 cases of posttraumatic endophthalmitis were evaluated retrospectively to determine which factors were associated with visual loss. All cases were treated with intravenous and intraocular antibiotics. Pars plana vitrectomy was performed in 15 (41.7) cases as an adjunct to treatment.Results:Patients ranged in age from 18 months to 83 years, and included 30 men (83) and 6 women (17). Intraocular foreign bodies were present in 6 patients (16.7), 9 (25) had corneal lacerations, 13 (36.1) had corneoscleral or scleral lacerations, and 8 (22.2) had ocular trauma of unknown type. Of the 36 eyes, 21 (58.3) had positive culture results, and 10 of these (27.8) had multiple organisms. The most common isolates wereStaphylococcusspecies (26.5),Streptococcusspecies (20.6), andBacillusspecies (14.7). In 4 cases the diagnosis was made 6 or more years after injury. Final visual acuity was 20/200 in 8 eyes (22.2) and 20/300 in 1 eye. In 17 cases (47.2), the eye was salvaged but visual acuity was 5/200 or worse, and 10 eyes (27.8) were lost to enucleation or phthisis bulbi.Conclusion:Prompt diagnosis and early treatment with intraocular and systemic antibiotics are important in the successful management of posttraumatic endophthalmitis. The use of pars plana vitrectomy was associated with a good visual outcome when used in select cases
机译:创伤后眼内炎是一种罕见的穿透性眼外伤并发症,可导致可能挽救的眼睛失明。方法&结肠;回顾性评估36例创伤后眼内炎,以确定哪些因素与视力丧失有关。所有病例均接受静脉注射和眼内注射抗生素治疗。在 15 例 (41.7%) 病例中进行了扁平肌玻璃体切除术作为治疗的辅助手段。结果&结肠;患者年龄从18个月到83岁不等,包括30名男性(83%)和6名女性(17%)。6例患者(16.7例)存在眼内异物,9例(25例)有角膜撕裂伤,13例(36.1%)有角膜巩膜或巩膜撕裂伤,8例(22.2例)有未知类型的眼外伤。在 36 只眼睛中,21 只 (58.3%) 的培养结果呈阳性,其中 10 只 (27.8%) 有多种微生物。最常见的分离株是葡萄球菌属(26.5%)、链球菌属(20.6%)和芽孢杆菌属(14.7%)。在4例病例中,诊断是在受伤后6年或更长时间。8 只眼睛的最终视力为 20/200 (22.2%),1 只眼睛的最终视力为 20/300。在17例(47.2%)中,眼睛被挽救,但视力为5/200或更差,10只眼睛(27.8%%)因眼球摘除或球痢炎而丢失。结论&结肠:及时诊断和早期使用眼内和全身抗生素治疗对于成功治疗创伤后眼内炎非常重要。在特定病例中使用扁平玻璃体切除术与良好的视觉结果相关

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