Résumé
PURPOSE: To evaluate the incidence, causative organism, clinical features, and visual outcomes of acute endophthalmitis following intravitreal injection. METHODS: For all intravitreal triamcinolone acetonide, bevacizumab, and lucentis injections performed in our outpatient clinic between January 2006 and June 2008, the number of injections, indications, type of administered drugs, and method of injection were investigated. The medical records of the patients with acute endoththalmitis were reviewed retrospectively. RESULTS: The total number of intravitreal injections was 10,153. The incidence of acute endophthalmitis for all intravitreal injections was 0.020% (2/10,153) with 0.030% (1/3,383) for the triamcinolone acetonide, 0.015% (1/6,552) for the bevacizumab, and 0.000% (0/218) for the ranibizumab drug injections. Streptococcus species were confirmed in the bacterial culture of two eyes with acute endotphthalmitis. After early vitrectomy and intravitreal antibiotics injection, one eye maintained vision but the other eye developed phthisis. CONCLUSIONS: Although the incidence of acute endophthalmitis following intravitreal injections performed in outpatient clinics is very low, due to the potentially fatal visual outcome after endophthalmitis, careful attention to aseptic injection technique is mandatory.
Sujets)
Humains , Établissements de soins ambulatoires , Antibactériens , Anticorps monoclonaux humanisés , Endophtalmie , Oeil , Incidence , Injections intravitréennes , Dossiers médicaux , Études rétrospectives , Streptococcus , Triamcinolone acétonide , Vision , Vitrectomie , Bévacizumab , RanibizumabRésumé
PURPOSE: To describe the rare condition of an infection of hydroxyapatite orbital implant in five patients who had undergone seemingly uncomplicated evisceration and implantation of hydroxyapatite orbital implant. METHODS: The infection of hydroxyapatite orbital implant developed from 6 months to 6 years (mean 3 years 4months) after evisceration and from 3months to 6years (mean 2years 7months) after drilling. In all cases, lid swelling, conjunctival injection and implant exposure were observed. In 3 cases, the hydroxyapatite orbital implant was removed and Medpor(R) implantation was done. In 2 cases, the hydroxyapatite orbital implant was removed and dermis fat graft was done simultaneously. RESULTS: In all five cases the inflammation signs disappeared and conjunctival sac was well formed for artificial eye fitting after treatment. CONCLUSIONS: We experienced 5 cases of infected hydroxyapatite orbital implant, and treated them successfully.