Способы лечения стафилококкового послеоперационного эндофтальмита (экспериментальное исследование)

[摘要] Introduction. Сhoice of treatment tactics of postoperative endophthalmitis is an actual problem of ophthalmosurgery. Purpose. Estimation of efficasy of different methods of treatment of postoperative endophthalmitis (for example experimental staphylococcus). Material and methods. 30 right eyes of 30 rabbits were operated (left eye was left for control) during experimental work. Phacoemulsification of lens was rendered in all rabbits as a first stage, at the end of the surgery 0.1 ml of staphylococcus epidermidis cells solution was injected intravitreally. In 16-18 hours signs of postoperative endophthalmitis on operated eyes of all the rabbits appeared. Then all the rabbits were divided randomly in 3 groups: 10 rabbits of the first group were treated surgically with intravitreal 1 mg vancomicin per 0.1 saline solution at the end of the surgery; 10 rabbits of the second group – vitrectomy with vitreous cavity replacement with saline and 1 mg vancomicin per 0.1  saline s.introduction; 10 rabbits of the third group – vitrectomy with vitreous cavity replacement with perftordecalin and 1 mg vancomicin per 0.1 saline s.introduction at the end of the surgery. Periods of control: 1st, 3rd,14th, 30th day after the surgery. The degree of inflammation reaction was estimated subjectively at biomicroscopy, objectively – quantitative determination of albumin flow in anterior chamber. Results. Treatment of the third group of rabbits was the most effective. Eyeballs of all rabbits were saved in this group. On the 14th day perftororganic compound was changed to 5700Cct silicon oil in 9 rabbits, perftordecalin was removed in 1 rabbit taking into consideration low eye inflammation reaction. In 4 rabbits of the second group there was no positive dynamics and eyeballs were lost up to 1 month. There was no positive effect of treatment in all rabbits of the first group, it was impossible to suppress inflammation completely in no case and eyeballs were lost up to 1 month. Conclusions. Taking into consideration the data vitrectomy surgery is necessary in severe cases of postoperative endophthalmitis. There is possibility to combine treatment with intravitral introduction of antibacterial medicine in case of tamponade of vitreal cavity with perftordecalin.

[学科分类] 眼科学

[关键词] staphylococcus postoperative endophthalmitis;vancomicin;vitrectomy;intravitreal introduction of antibacterial medicine;стафилококковый послеоперационный эндофтальмит;ванкомицин;витрэктомия