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玻璃体切割联合人工晶体植入术

孔源性视网膜脱离伴玻璃体出血六例

复杂性眼球穿通伤行玻璃体切除联合穿透性角膜移植术

目的：分析探讨玻璃体切除联合穿透性角膜移植术对复杂性眼球穿通伤的治疗价值。 方法；对18例复杂性眼球穿通伤致角膜瘢痕性混浊同时伴有玻璃体、视网膜病变患者的18只眼，应用临时人工角膜I期完成经睫状体平坦部的闭合式玻璃体切除、视网膜复位、穿透性角膜移植等联合手术。 结果：术后随访6个月一2年，14例角膜植片透明，16例视网膜复位。15例患者矫正视力为指数／1m以上，10只眼脱盲，6只眼脱残。 结论：应用现代显微手术设备和技巧，对严重眼前后节复杂性眼外伤患者，行玻璃体切除联合穿透性角膜移植术，可以使多数伤眼眼球保存和复明。 （中华眼底病杂志，1997，13：102-103）

Analysis of pathogenic factors and etiological characteristics of 531 patients with suppurative endophthalmitis

ObjectiveTo analyze pathogenic factors and etiological characteristics of suppurative endophthalmitis.MethodsA total of 531 consecutive patients (531 eyes) with suppurative endophthalmitis who were hospitalized in Qingdao Eye Hospital of Shandong Eye Institute from January 2006 to December 2015 were included in the study. Among them, 410 patients with 410 eyes were males (77.2%), 121 patients with 121 eyes were females (22.8%). The average age of the patients was 38.62±15.36 years. The relevant medical records were collected to analyze the pathogenic factors. Samples of aqueous humor, vitreous or other intraocular samples were taken under aseptic conditions for bacterial and fungal culture and in vitro drug sensitivity test.ResultsOcular trauma was the primary pathogenic factor of suppurative endophthalmitis (60.1%), other factors included postoperative endophthalmitis (19.0%), suppurative keratitis-related endophthalmitis (17.1%) and endogenous endophthalmitis (3.8%). Postoperative endophthalmitis mainly occured after cataract surgery. A total of 224 strains of organisms were isolated, among which the predominant organisms isolated were gram-positive bacteria (54.0%) and staphylococcus epidermidis was the most common (25.0%). The other pathogenic organisms were fungi (29.5%) and gram-negative bacteria (16.5%). Among the fungi, aspergillus (10.7%) was the dominant genus, followed by fusarium (9.8%). For gram-positive organisms, susceptibilities were vancomycin 97.4%, gatifloxacin 91.8%, fusidate acid 77.9% and levofloxacin 54.6%. For gram-negative organisms, susceptibilities were gatifloxacin 85.7%, levofloxacin 77.8%, tobramycin 71.4% and ceftazidime 62.5%. For fungal isolates, sensitivities were voriconazole 88.2% and amphotericin B 84.8%.ConclusionsOcular trauma is the main pathogenic factor of suppurative endophthalmitis, followed by postoperative endophthalmitis and suppurative keratitis-related endophthalmitis. Gram-positive bacteria are the major pathogenic organisms, especially staphylococcus epidermidis followed by fungal species, among which aspergillus and fusarium were the dominating pathogenic genus.