Early intravitreal injection of antibiotics to the curative effects of vitrectomy for exogenous endophthalnlitis / 眼科

Objective To investigate the surgical treatment and early intravitreal injection of antibiotics to the curative effects of vitrectomy for exogenous endophthalmitis. Design Retrospective case-controlled study. Participants From Jan 2000 to Dec 2004, 94 patients(94 eyes), diagnosed as endophthalmitis were evaluated retrospectively. Methods All patients underwent pars plana vitrectomy. 46 patients (46 eyes) underwent the intravitreal injection of antibiotics early before undergoing vitrectomy from 3 to 14 days (mean 5.6 days) (group Ⅰ). The other 48 patients (48 eyes) underwent vitrectomy directly (group Ⅱ). Postoperative follow-up ranged from 3 to 12 months (mean 7.5 months). Main Outcome Measures Visual acuity. Results The visual acuities of these 94 patients improved significantly after vitrectomy (P=0.000). The rate of curative effects in group Ⅰ was significantly higher than that of the group Ⅱ (P=0.029). According to the further analysis, the rates of curative effects of the patients underwent vitrectomy in 7 days were similar between group Ⅰ and group Ⅱ(P=0.692), but the rates of curative effects of the patients underwent vitrectomy after 7 days were obviously different between two groups (P=0.008). Conclusions Undergoing vitrectomy as early as possible is a good available method for the treatment of exogenous endophthalmitis. If the vitrectomy can not be undergone early, intravitreal injection of antibiotics in time before vitrectomy may increase the therapeutic effect of exogenous endophthalmitis obviously.

Vitrectomy in ocular perforating injury accompanied by intraorbital foreign body/ / 眼科

Vitrectomy was performed on 21 patients with ocular perforating (through-and-through) injury accompanied by intraorbital foreign body. The orbital foreign bodies in 3 cases were extracted during the operation. Functional visual success was obtained in 17 eyes (81%). Lower than 0.09 visual acuity was obtained in 8 eyes (38.1%); 0.1—0.4, in 10 eyes (47.6%); and higher than 1.0, in 1 eye (4.8%). Atrophy of the globe occurred in 2 eyes (9.5%) in which 1 eye has already been enucleated. The mean follow-up period was 12 months. The optimal operative time, the perforating injury with or without retinal detachment, and the extraction of orbital foreign body were discussed.