在治疗术后眼内炎中作为佐剂应用的玻璃体内地塞米松:一项前瞻性随机研究

来源 :世界核心医学期刊文摘.眼科学分册 | 被引量 : 0次 | 上传用户:ewen2005
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PURPOSE: To study whether intravitreal dexamethasone as adjuvant to intravitreal antibiotics improves the outcome in patients with suspected postoperative bacterial endophthalmitis. Design: Prospective randomized clinical trial. Setting: Tertiary referral center. Patient population: Twenty-nine consecutive patients with suspected postoperative bacterial endophthalmitis within 6 weeks of cataract surgery. Intervention: Patients underwent a vitreous biopsy followed by intravitreal injection of antibiotics (0.2 mg vancomycin and 0.05 mg gentamicin) and 400 μg dexamethasone or placebo. After 3-4 days the intravitreal injection of antibiotics and dexamethasone or placebo was repeated. Primary outcome measure: Snellen visual acuity at 3 and 12 months after treatment. Results: In 20/29 patients (69%) the vitreous cultures were positive. 13/29 patients received dexamethasone. Seven patients had a functionally lost eye (final vision of hand movements or less), in four due to retinal detachment. Visual acuity tended to be better in the dexamethasone treated patients than in those given placebo, at both 3 months (P=0.055) and 12 months (P=0.080). Conclusion: This small prospective, placebo-controlled series showed a trend towards a better visual outcome in patientswith suspected bacterial endophthalmitiswhen treatment with intravitreal antibiotics was combined with intravitreal dexamethasone. Our findings justify a larger multicenter randomized study. PURPOSE: To study whether intravitreal dexamethasone as adjuvant to intravitreal antibiotics improves the outcome in patients with suspected postoperativeoperative bacterial endophthalmitis. Design: Prospective randomized clinical trial. Setting: Tertiary referral center. Patient population: Twenty-nine consecutive patients with suspected postoperative surgical endopethalmitis within 6 weeks of cataract surgery. Intervention: Patients underwent a vitreous biopsy followed by intravitreal injection of antibiotics (0.2 mg vancomycin and 0.05 mg gentamicin) and 400 μg dexamethasone or placebo. After 3-4 days the intravitreal injection of antibiotics and dexamethasone or placebo was repeated. Primary outcome measure: Snellen visual acuity at 3 and 12 months after treatment. Results: In 20/29 patients (69%) the vitreous cultures were positive. 13/29 patients received dexamethasone. Seven patients had a functionally lost eye vision of hand movements or less), in four due to retinal detachment .Conclusion: This small prospective, placebo-controlled series showed a trend towards, was at both 3 months (P = 0.055) and 12 months (P = 0.080). a better visual outcome in patients with suspected bacterial endophthalmitiswhen treatment with intravitreal antibiotics was combined with intravitreal dexamethasone. Our findings justify a larger multicenter randomized study.
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李也青1961年生,湖北荆州人,荆州师院美术专业毕业获文学学士学位,1990年师承孙克先生,1992年入中国美院刘国辉教授中国人物画高研班深造。现为中国美术家协会会员、中国民主
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