白内障硝子体同時手術時の前房水・硝子体液細菌検出率

Incidence of microbial contamination in the aqueous and vitreous during simultaneous cataract and vitreous surgery

目的：白内障硝子体同時手術で採取された前房水と硝子体からの細菌検出率を検索し，硝子体システムとして従来の20ゲージ（G）と25Gを使った際の検出率の差を比較する。対象と方法：10か月間に白内障硝子体同時手術を行った213眼を対象とし，手術終了時に採取した前房水と硝子体液を培養した。85眼に20Gシステム，128眼に25Gシステムを用いた。結果：細菌検出率は前房水2.0％，硝子体液1.9％であった。前房水と硝子体の双方からの培養が陽性である症例はなかった。20Gシステムでは硝子体液から1.2％に，25Gシステムでは2.3％に細菌検出を認めた。結論：白内障硝子体同時手術では眼内への細菌侵入の機会が2倍になる。硝子体液からの細菌検出率において20Gシステムと25Gシステムの間に差はなかった。

Purpose：To evaluate microbial contamination in the aqueous and vitreous during cataract-vitreous surgery and to compare 20-and 25-gauge systems. Cases and Method：This study involved 213 eyes that received simultaneous cataract and vitreous surgery during a 10-month period. Specimens were obtained from aqueous and vitreous at the end of surgery and were cultured. Surgery was performed by 20-gauge system in 85 eyes and by 25-gauge system in 128 eyes. Results：Bacterial organisms were isolated in 2.0％ of aqueous and in 1.9％ of vitreous. There was no case that was positive both for aqueous and vitreous. The detection rate of bacteria in vitreous was 1.2％ in 20-gauge system,2.3％ in 25-gauge system. Conclusion：Incidence of bacterial contamination increases by two-fold in simultaneous cataract and vitreous surgery. There was no difference between 20- and 25-gauge systems regarding detection rate of bacterial contamination in the vitreous.