Outcomes and Prognostic Factors of Posttraumatic Endophthalmitis: A Three-Year Retrospective Study.
Outcomes and Prognostic Factors of Posttraumatic Endophthalmitis: A Three-Year Retrospective Study.
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外伤后眼内炎的结果和预后因素：三年回顾性研究
DOI：
10.1155/2021/5526998
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发表时间：
2021
影响因子：
1.9
通讯作者：
Fang X
中科院分区：
文献类型：
--
作者：
Ma J;Yu Y;Zhong Y;Mao X;Fang X
目的描述外伤性眼内炎(PTE)患者的临床特点、治疗和转归，并确定视力预后不良的危险因素。我们回顾了2017年至2019年期间在我们机构接受治疗的连续42名PTE患者的医疗记录。收集和分析每个患者的数据，包括人口统计特征、眼损伤细节、手术记录、患者结果和实验室结果。进行多变量分析以确定与视力不良相关的因素。在我们的系列中，男性(n = 36，85.7%)和60岁以下的患者(20-40岁，23.8%；40-60岁，57.14%)构成了全部队列的大部分。42例PTE患者中，39例(92.8%)最佳矫正视力(BCVA)比数指差。所有患者均行玻璃体切割手术(PPV)。59.5%(n = 25)的患者术后视力提高，33.3%(n = 14)达到或超过20/200。取净率为7.1%(n = 3)。在42例标本中，10只眼(23.8%)培养阳性。单因素分析显示，性别、职业、全身疾病、外伤来源、晶状体损伤、硅油填充、玻璃体内抗生素的使用、临产时的BCVA和细菌培养阳性等因素对最终的视力结果没有影响。与最佳矫正视力( <； 20/200和 ≥ 20/200)相关的特征包括年龄较大(P=0.035)、角膜巩膜伤口(与巩膜伤口相比)(P=0.047)、眼内异物滞留(P=0.006)、治疗 &> 3天(与 <； 1天相比)(P=0.033)、手术次数较多(P=0.033)。PTE是与不可逆性视力丧失相关的眼球穿通伤的严重并发症。我们的结果强调了早期进行治疗性PPV和IOFB摘除以获得更好的视觉效果的重要性。
To describe the clinical features, management, and outcomes of patients with posttraumatic endophthalmitis (PTE) and to determine risk factors for poor visual prognosis. We retrospectively reviewed the medical records of 42 consecutive patients presenting with PTE who were treated at our institution between 2017 and 2019. Each patient's data, including demographic characteristics, ocular injury details, surgical records, patient outcomes, and laboratory results, were collected and analyzed. Multivariate analysis was conducted to determine the factors associated with poor visual outcomes. In our series, male (n = 36, 85.7%) and patients below 60 years of age (20–40 years, 23.8%; 40–60 years, 57.14%) comprised most of the total cohort. On presentation, 39 (92.8%) of the 42 PTE patients presented best-corrected visual acuity (BCVA) worse than counting fingers. Pars plana vitrectomy (PPV) was performed in all the patients. 59.5% (n = 25) of the patients' BCVA improved after surgery and 33.3% (n = 14) achieved BCVA of 20/200 or better. The rate of evisceration was 7.1% (n = 3). Of the 42 specimens, the culture was positive in 10 (23.8%) eyes. By univariate analysis, factors including sex, occupation, systemic disease, source of trauma, lens injury, silicone oil tamponade, usage of intravitreal antibiotics, BCVA at presentation, and culture positive for any organism did not affect the final visual outcome. The features associated with poor BCVA (grouped as < 20/200 and ≥ 20/200) included older age (P=0.035), corneal-sclera wound (versus sclera wound) (P=0.047), retained intraocular foreign bodies (IOFBs) (P=0.006), treatment > 3 days (versus < 1 day) (P=0.033), and more times of surgeries (P=0.033). PTE is a severe complication of penetrating globe injuries associated with irreversible visual loss. Our results highlighted the importance of conducting early therapeutic PPV and IOFB removal to achieve better visual outcomes.
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