ABSTRACT
Objective To investigate the clinical feature and treatment outcome of paediatric posttraumatic endophthalmitis.Methods A retrospective case study was performed.Twenty-six paediatric posttraumatic endophthalmitis children with 26 eyes were enrolled in Shandong Eye Hospital from April 2014 to April 2017.The clinical features,causes of trauma,time and mode of treatment,complications and visual acuity were analyzed.The subjects were graded according to the prognostic status,and the prognosis of the children was compared among different treatment time,vitrectomy time,operation frequency and antibiotic application.Results Of 26 cases,including 20 males and 6 females,aged from 1 year to 13 years,the average age was (6.56±3.25) years.The subjects were divided into infant group (2 cases,7.69％),preschool group (10 cases,38.46％) and school age group (14 cases,53.85％).The main cause of injury was wire,accounting for 34.62％ (9/26).Syringe needles accounted for 15.38％ (4/26).Fireworks accounted for 11.54％ (3/26).All of the 26 cases received vitrectomy,24 cases combined with lens extraction (92.31％).Among the 26 cases,8 cases had no primary visual acuity record;in the remaining 18 cases,the visual acuity at last follow-up was significantly improved when compared with the preoperative primary visual acuity (x2 =7.385,P =0.033).The positive rate of pathogenic bacteria culture in aqueous humor and vitreous humor was 23.08％ (6/26),gram-positive cocci was the main pathogenic bacteria of posttraumatic endophthalmitis,which account for 83.3％ (5/6).The prognostic grade was grade 1 in 15 cases (57.7％),grade 2 in 7 cases (26.9％) and grade 3 in 4 cases (15.4％).There were significant differences in the number of prognostic grading cases among children with different hospitalizing time or vitrectomy time (all at P＜0.05).The hospitalizing time,time of vitrectomy,number of operations and systemic application of antibiotics were positively correlated with the prognosis grade (rs =0.580,0.414,0.428,0.535;all at P ＜ 0.05).Conclusions Children with posttraumatic endophthalmitis should undergo vitrectomy as early as possible,which can receive better prognosis.
ABSTRACT
AIM:To evaluate the efficacy of vitrectomy in combination with intravitreal dexamethasone and vancomycin Derfusion in the management of severe post-traumatic endophthalmitis.METHODS:30 eyes diagnosed as posttraumatic infectiouis endophthalmitis were analyzed retrospectivly from April 2004 to April 2006.All the patients underwent vitrecLomy in combination with intravitreal drugs perfusion and were followed up for 12 to 24 weeks.The visual acuity,traumatic causes and microorganisms culture were analyzed.RESULTS:There are significant reduction in inflammation at 3 months after surgery.Infectious symptoms were completely controlled in 97% of the Cases(29/30).Final visual acuity were improved in 93% of cases (28/30).Among traumatic causes,foreign body is the most common cause (57%).StaphylococCUS aureus is the commonest microorganism.CONCLUSION:Vitrectomy in combination with intravitreal dexamethasone and vancomydn peffusion iS the most effective method in the treatment of Severe posttraumatic endophthamitis.
ABSTRACT
PURPOSE: To evaluate the incidence, risk factors, clinical characteristics, treatment, and the visual prognosis of posttraumatic endophthalmitis. METHODS: Medical records of 322 eyes in 322 patients, who were diagnosed as penetrating ocular trauma from July 1996 to June 2002, were retrospectively reviewed. RESULTS: Posttraumatic endophthalmitis developed in 30 (9.3%) of the 322 patients. There was an increased relative risk of infection in cases with poor initial visual acuity, lens disruption, delayed primary repair, and delayed use of systemic antibiotics. Of the 30 cases with infection, 12 (40%) achieved visual acuity of 0.1 or greater. In cases with poor initial visual acuity and with lens disruption, visual outcome was poorer. CONCLUSIONS: Risk factors for the development of posttraumatic endophthalmitis were poor initial visual acuity, lens disruption, delayed primary repair, and delayed use of systemic antibiotics. Poor prognostic factors were poor initial visual acuity and lens disruption.