Case-control study of endophthalmitis after cataract surgery comparing scleral tunnel and clear corneal wounds
Case-control study of endophthalmitis after cataract surgery comparing scleral tunnel and clear corneal wounds
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DOI：
10.1016/s0002-9394(03)00202-2
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发表时间：
2003-08-01
影响因子：
4.2
通讯作者：
Thompson, PA
中科院分区：
文献类型：
--
作者：
Cooper, BA;Holekamp, NM;Thompson, PA
目的：研究白内障摘除术期间有或没有缝合的透明角膜切口与术后眼内炎之间可能存在的关联。设计：回顾性、比较、病例对照研究。方法：对 38 名接受培养阳性、急性白内障手术后眼内炎治疗的患者和 371 名随机选择的在转诊社区接受简单白内障手术的对照患者进行研究。将眼内炎患者白内障手术时的切口类型和缝线使用情况与对照组进行比较。采用Logistic回归方法对数据进行分析。结果：38例眼内炎患者中，17例（45%）有清晰的角膜切口，21例（55%）有巩膜隧道切口。在 371 名对照者中，76 名患者（20%）有清晰的角膜切口，295 名患者（80%）有巩膜隧道切口。透明角膜切口发生眼内炎的风险是巩膜隧道切口的三倍（比值比，3.36，95% 置信区间 = 1.67 至 6.78）。切口类型显着（chi(2) = 11.53，P =.0007）；透明的角膜切口更常与眼内炎相关。亚组分析显示缝合线的存在或不存在并不显着（chi(2) = 1.31，P = .2524）。结论：在这项回顾性病例对照研究中，与巩膜隧道切口相比，透明角膜切口被发现是急性白内障手术后眼内炎的具有统计学意义的危险因素。
PURPOSE: To study the possible association between clear corneal incision with or without placement of a suture during cataract extraction and postoperative endophthalmitis.DESIGN: Retrospective, comparative, case-controlled study.METHODS: Thirty-eight patients treated for culture-positive, acute postcataract surgery endophthalmitis, and 371 randomly selected control patients who underwent uncomplicated cataract surgery in the referring community were studied. Incision type and use of suture during cataract surgery of endophthalmitis patients were compared with the controls. The data were analyzed using logistic regression methods.RESULTS: Of the 38 patients with endophthalmitis, 17 patients (45%) had clear corneal incisions and 21 patients (55%) had a scleral tunnel incision. In 371 controls, 76 patients (20%) had clear corneal incisions and 295 patients (80%) had scleral tunnel incisions. Clear corneal incision was associated with a threefold greater risk of endophthalmitis than was scleral tunnel incision (Odds Ratio, 3.36, 95% Confidence Interval = 1.67 to 6.78). The type of incision was significant (chi(2) = 11.53, P =.0007); a clear corneal incision was more frequently associated with endophthalmitis. A subgroup analysis revealed that the presence or absence of a suture was not significant (chi(2) = 1.31, P =.2524).CONCLUSIONS: In this retrospective, case,controlled study, clear corneal incisions were found to be a statistically significant risk factor for acute postcataract surgery endophthalmitis when compared with scleral tunnel incisions.