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目的:探讨白内障摘除、人工晶状体植入术后眼内炎的易感因素、临床特点、治疗方法及效果。方法:回顾1997年6月至2001年8月,9例(9只眼)白内障摘除、人工晶状体植入术后眼内炎患者的易感因素、临床表现、治疗方法和结果,并作微生物学检查。结果:2例为糖尿病患者,2例患者有眼外伤史,1例为低蛋白血症患者。主要临床表现为眼红痛和视力障碍。9例患者中3只眼经抗生素、抗真菌药物治疗后,治愈;6只眼行玻璃体切除、晶状体后囊膜切除及人工晶状体取出术。5例患者保存了有用视力,4例眼球萎缩。微生物学检查:1例玻璃体培养发现D-型链球菌,3例房水涂片检查分别发现革兰氏阳性杆菌、革兰氏阴性杆菌和菌丝。结论:糖尿病、眼外伤、低蛋白血症可能是白内障摘除、人工晶状体植入术后眼内炎的易感因素。玻璃体手术、全身和局部抗生素或抗真菌药物的应用并联合使用糖皮质激素是治疗白内障摘除、人工晶状体植入术后眼内炎的有效手段。
Objective: To investigate the susceptibility factors, clinical characteristics, treatment methods and effects of endophthalmitis after cataract extraction and intraocular lens implantation. Methods: From June 1997 to August 2001, 9 cases (9 eyes) of cataract extraction, intraocular lens implantation after endophthalmitis in patients with susceptibility factors, clinical manifestations, treatment methods and results, and for microbiology an examination. Results: Two patients had diabetes mellitus, two patients had history of ocular trauma, and one patient had hypoalbuminemia. The main clinical manifestations of eye pain and visual impairment. Three of the nine patients were cured by antibiotics and antifungal drugs. Six patients underwent vitrectomy, posterior capsule resection and intraocular lens removal. Five patients had useful visual acuity, and 4 had atrophy of the eyeball. Microbiological examination: D-Streptococcus was found in one case of vitreous and Gram-positive bacilli, Gram-negative bacilli and mycelium were found in three cases of aqueous humor. Conclusion: Diabetes mellitus, ocular trauma and hypoalbuminemia may be susceptible factors for cataract extraction and intraocular lens implantation after intraocular lens implantation. The use of vitreous surgery, systemic and topical antibiotics or antifungal agents in combination with glucocorticoid is an effective treatment for endocrinitis after cataract extraction and intraocular lens implantation.