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K. Ishida, K. Mochizuki, T. Yamamoto; Incidence and Risk Factors of Late-Onset Bleb-Related Infection Following Trabeculectomy. Invest. Ophthalmol. Vis. Sci. 2007;48(13):830.
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To determine the incidence and risk factors of bleb-related infection following trabeculectomy
A retrospective chart review of all cases who underwent trabeculectomy or trabeculectomy combined with cataract surgery, with or without antifibrotic agents from January 1, 1985, through December 31, 2005 at our hospital was performed. The Kaplan-Meier survival method was used to estimate incidence of late-onset bleb-related infection including blebitis and endophthalmitis. Cox regression analysis was performed using sex, age, present of diabetes mellitus and/or systemic hypertension, laterality, type of glaucoma, number of previous incisional operations, preoperative lens status (i.e. phakia, apahkia, or pseudophakia), trabeculectomy performed without concurrent cataract surgery, use of adjunctive antimetabolites (i.e. Mitomycin C and 5-fluorouracil), filtering bleb location, presence of bleb leak, continuous use of antibiotics or steroid, and additional bleb needling procedure, to identify risk factors.
A total of 2,115 cases of 1,348 patients were included in the study. The average follow-up was 5.0 years. Fifty-five eyes (2.6 %) experienced an episode of bleb-related infection. Bleb leak was observed in 18.3% (388 cases). The cumulative incidence of bleb-related infection was 7.8 % at 12 years. Risk factors for bleb-related infection included presence of bleb leak (P<0.0001), younger age (P=0.02), presence of diabetes mellitus (P=0.02), and continuous use of antibiotics (P=0.03).
Bleb leakage is a significant risk factor for late-onset bleb-related infection. Continuous use of antibiotics after surgery may increase risk for infection.
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