鼻泪管阻塞时眼表微生物群的改变:眼内手术的临床意义。

IF 5.9 2区 医学 Q1 OPHTHALMOLOGY
Bahram Eshraghi, Leila Babaei, Ali Aghajani
{"title":"鼻泪管阻塞时眼表微生物群的改变:眼内手术的临床意义。","authors":"Bahram Eshraghi, Leila Babaei, Ali Aghajani","doi":"10.1016/j.survophthal.2025.09.018","DOIUrl":null,"url":null,"abstract":"<p><p>Nasolacrimal duct obstruction (NLDO) significantly alters the ocular surface microbiome, increasing bacterial load, polymicrobial colonization, and the presence of drug-resistant organisms. This microbial shift poses a serious risk for postoperative endophthalmitis following intraocular surgery. Patients with NLDO have up to a 100% conjunctival culture positivity rate, compared to 40% in normal eyes, with increased prevalence of pathogenic species such as Pseudomonas aeruginosa and Streptococcus pneumoniae. Preoperative screening using the Regurgitation on Pressure over the Lacrimal Sac (ROPLAS) test is recommended for all patients undergoing intraocular surgery; however, its low sensitivity necessitates selective use of lacrimal irrigation in high-risk individuals. Definitive management with dacryocystorhinostomy (DCR) reduces microbial burden, with normalization of flora typically occurring around 4 weeks postoperatively. In cases where DCR cannot be performed, alternative strategies such as topical/systemic antibiotics or dacryocystectomy may help mitigate infection risk. Even after successful DCR, ocular surface microbiome may resemble nasal microbiota, requiring continued vigilance during the perioperative period. These findings highlight the importance of identifying and managing NLDO before intraocular procedures to reduce the risk of vision-threatening complications.</p>","PeriodicalId":22102,"journal":{"name":"Survey of ophthalmology","volume":" ","pages":""},"PeriodicalIF":5.9000,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Altered ocular surface microbiome in nasolacrimal duct obstruction: Clinical Implications for intraocular surgery.\",\"authors\":\"Bahram Eshraghi, Leila Babaei, Ali Aghajani\",\"doi\":\"10.1016/j.survophthal.2025.09.018\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Nasolacrimal duct obstruction (NLDO) significantly alters the ocular surface microbiome, increasing bacterial load, polymicrobial colonization, and the presence of drug-resistant organisms. This microbial shift poses a serious risk for postoperative endophthalmitis following intraocular surgery. Patients with NLDO have up to a 100% conjunctival culture positivity rate, compared to 40% in normal eyes, with increased prevalence of pathogenic species such as Pseudomonas aeruginosa and Streptococcus pneumoniae. Preoperative screening using the Regurgitation on Pressure over the Lacrimal Sac (ROPLAS) test is recommended for all patients undergoing intraocular surgery; however, its low sensitivity necessitates selective use of lacrimal irrigation in high-risk individuals. Definitive management with dacryocystorhinostomy (DCR) reduces microbial burden, with normalization of flora typically occurring around 4 weeks postoperatively. In cases where DCR cannot be performed, alternative strategies such as topical/systemic antibiotics or dacryocystectomy may help mitigate infection risk. Even after successful DCR, ocular surface microbiome may resemble nasal microbiota, requiring continued vigilance during the perioperative period. These findings highlight the importance of identifying and managing NLDO before intraocular procedures to reduce the risk of vision-threatening complications.</p>\",\"PeriodicalId\":22102,\"journal\":{\"name\":\"Survey of ophthalmology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":5.9000,\"publicationDate\":\"2025-09-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Survey of ophthalmology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.survophthal.2025.09.018\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Survey of ophthalmology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.survophthal.2025.09.018","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0

摘要

鼻泪管阻塞(NLDO)显著改变眼表微生物组,增加细菌负荷、多微生物定植和耐药生物的存在。这种微生物转移对眼内手术后的眼内炎有严重的风险。NLDO患者的结膜培养阳性率高达100%,而正常眼睛的阳性率为40%,病原菌如铜绿假单胞菌和肺炎链球菌的患病率增加。建议所有接受眼内手术的患者术前使用泪囊压反流(ROPLAS)试验进行筛查;然而,由于其敏感性低,需要在高危人群中选择性使用泪道冲洗。泪囊鼻腔吻合术(DCR)的最终治疗减少了微生物负担,通常在术后4周左右出现菌群的正常化。在不能进行DCR的情况下,局部/全身抗生素或泪囊切除术等替代策略可能有助于减轻感染风险。即使在DCR成功后,眼表微生物群可能与鼻微生物群相似,在围手术期需要持续警惕。这些发现强调了在眼内手术前识别和处理NLDO的重要性,以减少视力威胁并发症的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Altered ocular surface microbiome in nasolacrimal duct obstruction: Clinical Implications for intraocular surgery.

Nasolacrimal duct obstruction (NLDO) significantly alters the ocular surface microbiome, increasing bacterial load, polymicrobial colonization, and the presence of drug-resistant organisms. This microbial shift poses a serious risk for postoperative endophthalmitis following intraocular surgery. Patients with NLDO have up to a 100% conjunctival culture positivity rate, compared to 40% in normal eyes, with increased prevalence of pathogenic species such as Pseudomonas aeruginosa and Streptococcus pneumoniae. Preoperative screening using the Regurgitation on Pressure over the Lacrimal Sac (ROPLAS) test is recommended for all patients undergoing intraocular surgery; however, its low sensitivity necessitates selective use of lacrimal irrigation in high-risk individuals. Definitive management with dacryocystorhinostomy (DCR) reduces microbial burden, with normalization of flora typically occurring around 4 weeks postoperatively. In cases where DCR cannot be performed, alternative strategies such as topical/systemic antibiotics or dacryocystectomy may help mitigate infection risk. Even after successful DCR, ocular surface microbiome may resemble nasal microbiota, requiring continued vigilance during the perioperative period. These findings highlight the importance of identifying and managing NLDO before intraocular procedures to reduce the risk of vision-threatening complications.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Survey of ophthalmology
Survey of ophthalmology 医学-眼科学
CiteScore
10.30
自引率
2.00%
发文量
138
审稿时长
14.8 weeks
期刊介绍: Survey of Ophthalmology is a clinically oriented review journal designed to keep ophthalmologists up to date. Comprehensive major review articles, written by experts and stringently refereed, integrate the literature on subjects selected for their clinical importance. Survey also includes feature articles, section reviews, book reviews, and abstracts.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信