Analysis of visual impairment and therapeutic effects of intraocular inflammation after cataract surgery
Objective To summarize and analyze the clinical characteristics and hospitalization treatment effects of endophthalmitis after cataract surgery.Methods The medical records of patients diagnosed with postoperative endo-phthalmitis after cataract surgery from 2018 to 2023 were collected retrospectively.The onset time,pathogenic bacteria and visual acuity changes of 48 cases of endophthalmitis after cataract surgery were analyzed.Results Among the col-lected clinical data of 48 cases of intraocular inflammation after cataract surgery,the vast majority of cases(95.83%)had initial visual acuity in a blind state,with 3 cases(6.25%),23 cases(47.92%),14 cases(29.17%),and 6 cases(12.5%)classified as index(CF),manual(HM),light perception(LP),and no light perception,respectively.The vast majority(95.83%)were postoperative acute endophthalmitis,with 12 cases(25.00%)experiencing endophthalmitis within 4 days after the surgery,26 cases(54.17%)experiencing endophthalmitis symptoms within 2 weeks after the sur-gery,and 7 cases(14.58%)experiencing endophthalmitis symptoms within 2～6 weeks after the surgery.The total posi-tive rate of bacterial culture was 52.5%.Among the 21 cases of postoperative infectious endophthalmitis confirmed by bac-terial culture,the vast majority were gram negative bacterial infections(20/21,95.24%)and opportunistic pathogens(19/21,90.48%).The visual impairment grading of patients in the negative bacterial culture group was improved after the treat-ment(P<0.05),while patients in the positive bacterial culture group showed no significant improvement in visual impair-ment grading after the treatment(P>0.05).During hospitalization,both anterior chamber antibiotic irrigation and intravit-real injection combined with adjuvant therapy,as well as direct vitrectomy and intravitreal injection combined with adju-vant therapy,can improve the grading of visual impairment(P<0.05),but the additional advantages of vitrectomy sur-gery have not been confirmed.Conclusions The high-risk period for postoperative endophthalmitis is from 4 days to 2 weeks after cataract surgery,mainly due to gram positive opportunistic bacterial infections.Compared with the combination therapy of anterior chamber antibiotic irrigation and intravitreal antibiotic injection,the combination therapy of vitrectomy and intravitreal antibiotic injection did not show any additional therapeutic advantages.
万方数据
维普
