ENDOPHTHALMITIS IN WESTERN AUSTRALIA (1980-2002): INCIDENCE, MANAGEMENT AND EFFECTIVENESS OF CHEMOPROPHYLAXIS

眼内炎是一种严重的视力，威胁到眼睛内腔的感染。虽然眼内炎不是眼科手术后常见的并发症，但在澳大利亚，白内障手术后每年都会发生200例这种严重威胁视力的感染。这种情况不仅让患者和外科医生都非常痛苦，而且每年用于治疗这种感染的费用约为400万澳元。此外，在预防感染的方法上也有大量支出，但迄今尚未证明这些方法是有益的。我们的研究将使用一个由顾问眼科医生、公共卫生研究人员、生物统计学家和健康经济学家组成的多学科团队来评估1980-2002年间西澳地区眼内炎的影响(约480例)。以人口为基础的西澳连接数据库提供了一个独特的机会，以产生将是最大的眼内炎人口研究。这项研究的数据将为制定预防白内障手术后眼内炎的最佳实践治疗指南提供重要信息。这项研究的意义将是获得有关眼内炎的临床流行病学和真实成本的准确信息。通过研究眼内炎患者的记录，并将他们与白内障手术后没有发生术后眼内炎的匹配患者进行比较，我们将通过确定导致感染的潜在因素来表征这种严重并发症的风险。我们还将更好地了解用于预防感染的方法的效果。使用以全体人口为基础的研究来评估预防眼内炎的方法以前从未进行过，这将对卫生政策和最佳做法产生重大有利影响，不仅在澳大利亚，而且在国际上也是如此。

Endophthalmitis is a serious sight threatening infection of the internal cavities of the eye. Although endophthalmitis is not a common post-operative complication of eye surgery, 200 cases of this serious sight threatening infection occur each year in Australia following cataract surgery. Not only is this condition extremely distressing to the patients and surgeons alike, around A$4 million per year is spent each year treating the infection. Also, there is significant expenditure on methods to prevent the infection that have not, as yet, been demonstrated beneficial. Our study will use a multidisciplinary team consisting of consultant ophthalmologists, public health researchers, a biostatistician and health economist to assess the impact of endophthalmitis in WA from 1980-2002 (around 480 cases). The population-based WA Linked Database provides a unique opportunity to produce what will be the largest population study of endophthalmitis. Data from the study will provide important information to develop best-practice treatment guidelines to prevent endophthalmitis following cataract surgery. The significance of this study will be that accurate information on the clinical epidemiology and true cost of endophthalmitis will be obtained for WA. By studying the records of patients with endophthalmitis and comparing them with matched patients, who did not have post-operative endophthalmitis following cataract surgery, we will characterise the risks for this severe complication by identifying the underlying factors that are responsible for the infection. We will also better understand the effect of methods used to prevent the infection. The use of a whole population-based study to assess methods of endophthalmitis prevention has not been done before and will have a significant beneficial impact on health policy and best-practice, not only in Australia, but also internationally.