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学科主题: 临床医学
题名:
The incidence of postoperative endophthalmitis after cataract surgery in China: a multicenter investigation of 2006-2011
作者: Yao, Ke1,2; Zhu, Yanan1,2; Zhu, Zhihong3; Wu, Jianjun4; Liu, Yizhi5; Lu, Yi6; Hao, Yansheng7; Bao, Yongzhen8; Ye, Jian9; Huang, Yusen10; Li, Zhaohui11; Shentu, Xingchao1,2; Yu, Yibo1,2
关键词: Epidemiology
刊名: BRITISH JOURNAL OF OPHTHALMOLOGY
发表日期: 2013-10-01
DOI: 10.1136/bjophthalmol-2013-303282
卷: 97, 期:10, 页:1312-1317
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Ophthalmology
研究领域[WOS]: Ophthalmology
关键词[WOS]: POSTCATARACT ENDOPHTHALMITIS ; IRRIGATING SOLUTIONS ; PHACOEMULSIFICATION ; CONTAMINATION ; ANTIBIOTICS ; VANCOMYCIN ; OUTCOMES ; PROPHYLAXIS ; POPULATION ; VITRECTOMY
英文摘要:

Aims To estimate the cumulative incidence of postoperative endophthalmitis, identify risk factors and determine clinical outcomes in China.

Methods Medical records were reviewed for all patients with acute-onset endophthalmitis after cataract surgery from January 2006 to December 2011 at eight eye centres of tertiary care hospitals in China.

Results Sixty-six cases of presumed endophthalmitis occurred after 201757 cataract surgeries, yielding a cumulative incidence of 0.033% (95% CI 0.025 to 0.041). Logistic regression analysis revealed that the risk of endophthalmitis increased with intraoperative communication with vitreous (multivariate OR 9.96; 95% CI 4.54 to 21.84; p<0.001). After a median follow-up of 153days, best-corrected visual acuity in the affected eye was more than 20/70 in 29/65 (44.6%) patients, and more than 20/40 in 20/65 (30.8%). A predictor of good visual acuity was baseline acuity of counting fingers or better (OR 6.25; 95% CI 2.13 to 18.33). Of 64 cases, 25 (39.1%) were culture positive. Coagulase-negative Staphylococcus and Pseudomonas species were the most common organisms isolated, accounting for 72.0% of the culture-positive cases (18/25). Two eye centres that used a combination of a high concentration vancomycin (1mg/0.1mL intracameral vancomycin injection or 100 mu g/mL vancomycin in irrigating solution) and tobramycin as infection prophylaxis achieved a lower incidence of endophthalmitis than other centres (p<0.001).

Conclusions The incidence of acute postoperative endophthalmitis after cataract surgery in tertiary care hospitals of China was 0.033%. Intraoperative communication with vitreous was a major risk factor for developing endophthalmitis. Prophylactic use of a high-concentration vancomycin and tobramycin may play a positive role in the prevention of postoperative endophthalmitis after cataract surgery.

语种: 英语
所属项目编号: 81130018 ; 2012BAI08B01 ; 2009R50039 ; 2011E10006
项目资助者: National Natural Science Foundation of China ; National Twelfth Five-Year Plan Foundation of China ; Zhejiang Key Innovation Team Project of China ; Zhejiang Key Laboratory Fund of China ; Project of National Clinical Key Discipline of Chinese Ministry of Health
WOS记录号: WOS:000324639200019
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/55001
Appears in Collections:北京大学第三临床医学院_眼科_期刊论文

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作者单位: 1.Shandong Eye Inst, Qingdao, Peoples R China
2.Key Lab Ophthalmol Zhejiang Prov, Hangzhou, Zhejiang, Peoples R China
3.Zhongshan Ophthalm Ctr, Guangzhou, Guangdong, Peoples R China
4.Zhejiang Univ, Ctr Eye, Coll Med, Affiliated Hosp 2, Hangzhou 310009, Zhejiang, Peoples R China
5.Zhejiang Univ, Key Lab Cardiovasc Dis Zhejiang Prov, Coll Med, Affiliated Hosp 2, Hangzhou 310009, Zhejiang, Peoples R China
6.Zhejiang Univ, Coll Sci, Dept Math & Stat, Hangzhou 310009, Zhejiang, Peoples R China
7.Fudan Univ, Dept Ophthalmol, Eye & ENT Hosp, Shanghai 200433, Peoples R China
8.Peking Univ, Dept Ophthalmol, Hosp 3, Beijing 100871, Peoples R China
9.Peking Univ, Dept Ophthalmol, Peoples Hosp, Beijing 100871, Peoples R China
10.Third Mil Med Univ, Dept Ophthalmol, Da Ping Hosp, Chongqing, Peoples R China
11.301 Mil Hosp, Dept Ophthalmol, Beijing, Peoples R China

Recommended Citation:
Yao, Ke,Zhu, Yanan,Zhu, Zhihong,et al. The incidence of postoperative endophthalmitis after cataract surgery in China: a multicenter investigation of 2006-2011[J]. BRITISH JOURNAL OF OPHTHALMOLOGY,2013,97(10):1312-1317.
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