Nosocomial acute onset postoperative endophthalmitis survey - A 10-year review of incidence and outcomes
Nosocomial acute onset postoperative endophthalmitis survey - A 10-year review of incidence and outcomes
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DOI：
10.1016/s0161-6420(98)96000-6
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发表时间：
1998-06-01
期刊：
影响因子：
13.7
通讯作者：
Newton, J
中科院分区：
文献类型：
--
作者：
Aaberg, TM;Flynn, HW;Newton, J
目的：本研究的目的是评估急性发作（术后 6 周内）术后眼内炎的发生率，并评估在一个机构 10 年治疗后的视力结果。 患者和方法：这项回顾性研究回顾了 1984 年 1 月 1 日至 1994 年 12 月 30 日期间在迈阿密医科大学巴斯科姆帕尔默眼科研究所 Anne Bates Leach 眼科医院进行的所有手术病例 中心，针对医院内急性发作的术后眼内炎的发生情况。结果：眼内手术后急性发作的术后眼内炎的总体 10 年发生率为 0.093%（54/58，123）。按手术类别划分，经培养证明急性发作的术后眼内炎的发生率如下：使用或不使用人工晶状体（IOL）的白内障手术（0.082％，34/41，654），平坦部玻璃体切除术（PPV）（0.046％，3/6557），穿透性角膜移植术（0.178％， 5/2805)、二次人工晶状体植入术(0.366%, 5/1367)、青光眼手术(0.124%, 4/3233)、小梁切除术和白内障联合手术(0.114%, 2/1743)、穿透性角膜移植术和白内障联合手术(0.194%, 1/515)。之后的敏锐度 眼内炎治疗率为20/200。眼内炎手术治疗后的中位视力如下：白内障手术加或不加IOL（20/133）、PPV（无光感）、穿透性角膜移植术（2/200）、二次人工晶状体植入术（20/40）、青光眼手术（20/80）以及联合小梁切除术和白内障手术加或不加IOL (20/150)。结论：眼内手术后眼内炎的总体发生率为0.093%。二次人工晶状体植入术后眼内炎的发生率高于白内障摘除术后（P=0.008，Fisher精确检验）。治疗后，PPV 后发生眼内炎的患者的视力结果比白内障摘除、青光眼手术或二次 IOL 植入后更差（P < 0.05，方差分析，邓肯多范围检验）。二次人工晶状体植入患者眼内炎治疗后的视力结果优于穿透性角膜移植术或PPV（P < 0.05，方差分析，邓肯多重范围检验）。大型教学中心十年回顾的结果可以作为其他中心和未来研究的比较来源。
Objective: The purpose of the study was to evaluate the incidence of acute-onset (within 6 weeks after surgery) postoperative endophthalmitis and to assess the visual acuity outcomes after treatment over a 10-year period at one institution.Patients and Methods: This retrospective study reviews all surgical cases performed between January 1, 1984 and December 30, 1994 at the Anne Bates Leach Eye Hospital, Bascom Palmer Eye Institute, University of Miami Medical Center, for the occurrence of nosocomial acute-onset postoperative endophthalmitis.Results: The overall 10-year incidence of acute-onset postoperative endophthalmitis after intraocular surgery was 0.093% (54/58, 123). The incidences of culture-proven acute-onset postoperative endophthalmitis by surgical category were as follows: cataract surgery with or without intraocular lens (IOL) (0.082%, 34/41, 654), pars plana vitrectomy (PPV) (0.046%, 3/6557), penetrating keratoplasty (0.178%, 5/2805), secondary IOL placement (0.366%, 5/1367), glaucoma surgeries (0.124%, 4/3233), combined trabeculectomy and cataract surgery (0.114%, 2/1743), and combined penetrating keratoplasty and cataract surgery (0.194%, 1/515).The median visual acuity after endophthalmitis treatment was 20/200. The median visual acuities after endophthalmitis treatment by procedure were as follows: cataract surgery with or without IOL (20/133), PPV (no light perception), penetrating keratoplasty (2/200), secondary IOL implantation (20/40), glaucoma surgery (20/80), and combined trabeculectomy and cataract surgery with or without IOL (20/150).Conclusions: The overall incidence of endophthalmitis after intraocular surgery was 0.093%. The incidence of endophthalmitis was higher after secondary IOL implantation than after cataract extraction (P = 0.008, Fisher's exact test). After treatment, the visual acuity outcomes were worse in the patients who developed endophthalmitis after PPV than after cataract extraction, glaucoma procedures, or secondary IOL implantation (P < 0.05, analysis of variance, Duncan's multiple range test). Acuity outcomes after treatment of endophthalmitis were better among the patients with secondary IOL implantation than after penetrating keratoplasty or PPV (P < 0.05, analysis of variance, Duncan's multiple range test). The results of this 10-year review from a large teaching center may serve as a source of comparison for other centers and future studies.