Epidemiological Characteristics And Therapeutic Effects Of Infectious Endophthalmitis

Objective To explore the pathogenic causes,pathogenic bacteria,therapeutic methods and therapeutic effects of infectious endophthalmitis.Methods The causes,etiological examination,treatment methods and therapeutic effects of 177 patients(179 eyes)with infectious endophthalmitis admitted to the Ophthalmic Center of The Second People's Hospital of Foshan from 2012 to 2018 were retrospectively analyzed.Results Infective endophthalmitis was 177 cases,179 eyes,121 males and 56 females.91 cases of right eye,84 cases of left eye and 2 cases of both eyes;The average age was(55.25±16.60)years old,ranging from 8 to 87 years old.The incidence rate is highest in the 18-60 age group.104 cases(104 eyes)of endophthalmitis caused by ocular trauma,including 31 cases(31 eyes)of foreign body injury,70 cases(70 eyes)of penetrating injury,2 cases(2 eyes)of rupture injury and 1 case(1 eye)of explosive injury;51 cases(51 eyes)of endophthalmitis after intraocular surgery,including 38cases(38 eyes)after cataract surgery,7 cases(7 eyes)after vitrectomy,5 cases(5 eyes)after glaucoma surgery,and 1 case(1 eye)after intravitreal drug injection.Endogenous endophthalmitis in 16 cases(18 eyes);Comeal ulcer in 6 cases(6 eyes).41 cases were positive for pathogenic culture,including 31 cases of bacteria,7 cases of fungi,3 cases of bacteria combined with fungi,14 cases of pathogenic bacteria were staphylococcus,and staphylococcus epidermidis was the most common.31 cases(31 eyes)of exogenous endophthalmitis were positive in pathogenic culture,accounting for 37.80%,while 10 cases(10 eyes)of endogenous endophthalmitis were positive in pathogenic culture,accounting for 71.43%.Chi-square test showed that the difference was statistically significant(X2=5.525,P=0.019).The positive rate of pathogenic microorganism culture in patients with exogenous endophthalmitis was significantly lower than that in patients with endogenous endophthalmitis.After treatment,18 cases(18 eyes)of infection could not be controlled,and enucleation or enucleation of ocular contents were carried out.159 cases(161 eyes)of infection were controlled,and the eyeball preservation rate was 89.94%.41 cases(41 eyes)of exogenous endophthalmitis can be controlled by drug therapy and/or intravitreal drug injection.Among them,17 cases(17 eyes)of traumatic endophthalmitis,accounting for 16.35%,and 24 cases(24 eyes)of endophthalmitis after intraocular surgery,accounting for 47.06%.Chi-square test shows that the difference is statistically significant(X2=16.591,P=0.000).The success rate of drug therapy and/or intravitreal drug injection treatment for postoperative endophthalmitis is higher than that for traumatic endophthalmitis.108 cases(108 eyes)underwent vitrectomy,106 cases(106 eyes)had intraocular inflammation control,accounting for 98.15%,13 cases(13 eyes)had visual acuity greater than 0.05 before surgery,accounting for 12.04%,59 cases(59 eyes)had visual acuity greater than 0.05 after surgery,accounting for 54.63%.Chi-square test showed that the difference between the two was statistically significant(X2=44.08,P=0.000),suggesting that postoperative vision after vitrectomy was improved compared with preoperative vision.Complications occurred in 45 cases(45 eyes)of infectious endophthalmitis after vitrectomy,accounting for 41.67%,including retinal detachment in 15 cases(15 eyes),accounting for 13.89%.After treatment,23 eyes had no light perception,10 eyes had light perception,13 eyes had manual operation,24 eyes had index,0.02?0.1 20 eyes,0.1?0.3 26 eyes,0.4?0.6 48 eyes,and 15 eyes above 0.7.Rank sum test showed that the difference was statistically significant(Z=-7.408,P=0.000),and the vision after treatment was improved compared with that before treatment.Conclusions The incidence of traumatic endophthalmitis is highest in young and middle-aged men.Intraocular inflammation after intraocular surgery is more common in cataract surgery.Staphylococcus epidermidis was the main pathogen.The positive rate of exogenous endophthalmitis pathogenic microorganism culture is significantly lower than endogenous endophthalmitis.Drug therapy and/or intravitreal drug injection have higher success rate in controlling endophthalmitis after intraocular surgery than traumatic endophthalmitis.Retinal detachment is the most common complication after vitrectomy,accounting for 13.89%.Timely administration of intravitreal injection and vitrectomy can achieve good therapeutic effects.