Visual Outcomes and Prognostic Factors after Pars Plana Vitrectomy for Traumatic Endophthalmitis.
Visual Outcomes and Prognostic Factors after Pars Plana Vitrectomy for Traumatic Endophthalmitis.
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DOI：
10.1155/2017/5851318
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发表时间：
2017
影响因子：
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通讯作者：
Zhou Y
中科院分区：
文献类型：
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作者：
Jiang T;Jiang J;Wang R;Lei J;Zhou Y
目的。目的：评价玻璃体切割手术治疗外伤性眼内炎后的视力及预后因素。方法。本文回顾性分析121例（121只眼）外伤性眼内炎患者行玻璃体切割手术的病历。结果：121例患者，年龄6 ~ 71岁，均行PPV手术。113例患者术后最佳矫正视力（BCVA）改善，其中60%优于手指计数（FC）。良好的最终视觉预后与以下因素显著相关：创伤至初始治疗间隔时间小于12小时（40%对98%，P < 0.001）、创伤至PPV治疗间隔时间小于24小时（62%对98%，P < 0.001）、撕裂伤长度小于10毫米（63%对96%，P < 0.001）、VA优于LP(42%对96%；P < 0.001)，而性别、撕裂类型、IOFB或视网膜脱离的存在以及硅油填塞的使用并不是导致BCVA改善的显著因素。43.8%的标本检出细菌，绝大多数为无毒微生物。结论。玻璃体切割手术是创伤性眼内炎的首选治疗方法。及时的治疗、及时的玻璃体切除术、较短的裂口长度和较好的视觉表现与良好的最终视力预后显著相关。
Purpose. To evaluate visual outcomes and identify prognostic factors after pars plana vitrectomy (PPV) surgery for traumatic endophthalmitis. Methods. Medical records of 121 consecutive patients (121 eyes) diagnosed with traumatic endophthalmitis that had undergone pars plana vitrectomy were retrospectively reviewed. Results. 121 patients, aged from 6 to 71 years, all underwent PPV surgery. 113 cases had improved best corrected visual acuity (BCVA) after surgery and 60% of them obtained BCVA better than fingers counting (FC). Good final visual prognosis was significantly associated with time between trauma and initial treatment less than 12 hrs (40% versus 98%; P < 0.001), time between trauma and PPV treatment less than 24 hrs (62% versus 98%; P < 0.001), laceration length less than 10 mm (63% versus 96%; P < 0.001), and presenting VA better than LP (42% versus 96%; P < 0.001), while gender, type of laceration, presence of IOFB or retinal detachment, and the use of silicone oil tamponade were not significant factors resulting in better BCVA. Bacteria were identified in 43.8% of specimens and most of the microorganisms were identified as nonvirulent ones. Conclusions. Pars plana vitrectomy surgery was preferred as a primary treatment option for traumatic endophthalmitis. A good final visual prognosis was significantly associated with timely treatment, prompt vitrectomy surgery, shorter length of laceration, and better presenting visual acuity.