眼内膜炎管理中的争议:一项为期5年的回顾性队列研究
Ohisa Harley1,2, Yufilia Suci Amelia3, Elsa Gustianty3,4,5
1Doctoral Program in Medical Sciences, Faculty of Medicine, Padjadjaran University, Ir. Soekarno Street Km 21, Jatinangor, Bandung, 45363, West Java, Indonesia. ohisa23001@mail.unpad.ac.id.
Journal of ophthalmic inflammation and infection
|March 17, 2025
概括
早期的帕斯普拉纳视切除术 (PPV) 带有内抗生素显著改善了术后内炎的视力. 关键的负面预后因素包括hypopyon和升高的眼内压力,强调迅速的临床管理.
科学领域:
- 眼科医生 眼科 眼科
- 传染性疾病 传染性疾病
背景情况:
- 手术后内眼炎带来明显的视力丧失风险,延迟治疗会加剧结果.
- 目前仅基于视觉结果的管理策略仍然是争论的主题.
研究的目的:
- 评估早期帕斯普拉纳视切除术 (PPV) 与视内抗生素相结合的疗效,以提高视力敏度和减轻术后内炎的并发症.
- 确定PPV后视力恢复的预后指标.
- 评估不同抗生素治疗方案和辅助类固醇治疗对视觉结果和炎症控制的影响.
主要方法:
- 一项回顾性队列研究分析了2019-2023年间40例手术后内炎病例.
- 数据包括人口统计数据,手术史,培养结果,治疗方法和最好的视力敏度 (BCVA) 在基线和视内切除术后三个月.
主要成果:
- 早期的PPV和内抗生素导致中位数logMAR BCVA (2.0到0.4,p<0.05) 的显著改善.
- 高眼内压,低眼压和手术前>7天是视觉结果的显著负面预测因素.
- 抗生素治疗和类固醇使用没有显著影响视觉恢复或并发症.
结论:
- 早期使用内抗生素的PPV是术后内炎的有效初级治疗方法,可以改善视觉结果.
- 基于临床症状的及时管理,而不是仅仅等待培养结果,至关重要.
- 升高的眼内压力和hypopyon是关键的负面预后因素,需要注意.
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