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백내장수술 후 절개부위감염의 치료 결과 및 치료 실패의 위험요인

Treatment Outcome of Wound Infection after Cataract Surgery and Risk Factors of Treatment Failure

대한안과학회지 2018년 59권 4호 p.319 ~ 324
KMID : 0360220180590040319
이동규 ( Lee Dong-Kyu ) - 전남대학교 의과대학 안과학교실

문현식 ( Moon Hyun-Sik ) - 전남대학교 의과대학 안과학교실
지영석 ( Ji Yong-Sok ) - 전남대학교 의과대학 안과학교실
윤경철 ( Yoon Kyung-Chul ) - 전남대학교 의과대학 안과학교실

Abstract

Purpose: To evaluate factors affecting wound infection after cataract surgery, and treatment outcomes.

Methods: In this retrospective study, we included 20 patients (20 eyes) who experienced wound infection after cataract surgery (phacoemulsification with intraocular lens implantation) between January 2005 and January 2017. Only those who yielded positive microbial smears were selected. All patients were assigned to a “treatment success group” (remission of infection) or a “treatment failure group” (aggravation of infection or a need for surgical intervention to treat an infectious complication). The demographic, clinical and microbiological features of the two groups were compared and binary logistic regression analyses were performed to identify factors affecting treatment failure.

Results: Wound infection developed at 12.25 ± 20.21 days (range 5 to 45 days) after cataract surgery. Sixteen patients developed bacterial and four developed fungal keratitis. Of the 20 patients, 13 (65.0%) were treated successfully and 7 (35.0%) were not. In univariate analyses, diabetes (p = 0.035), incisional suturing (p = 0.038), combined endophthalmitis (p = 0.001), and fungal infection (p = 0.021) were associated with treatment failure. Multivariate analyses showed that combined endophthalmitis (p = 0.001) and fungal infection (p = 0.044) were significant risk factors for treatment failure.

Conclusions: Cataract wound infection is rare but constitutes a serious complication. Combined endophthalmitis and fungal infection are associated with poor treatment outcomes.
KeyWords

Cataract surgery, Complication, Infection
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