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Rana J. Mady, Albert S. Khouri, Bart K. Holland, Lisa M. Athwal, Robert D. Fechtner, Paul J. Lama, Marco A. Zarbin, Neelakshi Bhagat; Intraocular Pressure Outcomes Following Endophthalmitis Associated with Glaucoma Surgery. Invest. Ophthalmol. Vis. Sci. 2011;52(14):638.
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To determine long-term intraocular pressure (IOP) outcomes and risk factors for failure following treatment of glaucoma surgery associated endophthalmitis.
Retrospective review of 17 eyes that presented with glaucoma surgery (16 trabeculectomy, 1 shunt drainage device) related endophthalmitis at University Hospital in Newark, NJ from 2001 to 2008. Mean follow-up time was 21 months (range 2 months to 5 years). "Failure" was defined as either an elevated IOP (22mmHg or more at 3 consecutive visits) or repeat glaucoma surgery. Kaplan Meier curve was used to analyze failure rate and Cox proportional hazards model to analyze the effects of pertinent variables on survival. Parameters analyzed include age, race, lens type, years between surgery and endophthalmitis, number of glaucoma medications at presentation and type of endophthalmitis treatment.
Of 17 eyes, 9 eyes (53%) failed; 7 required surgery (repeat trab (4 eyes), shunt (2 eyes), revision of shunt (1 eye)). Mean IOP at last follow-up was 31mmHg. IOP was controlled (21mmHg or less) in 7 eyes (41%), 5 without and 2 with medication; mean IOP was 12mmHg. Median survival time was 24 months. Age greater than 65 years and black race increased risk of failure (both at p=0.0008) while phakic lens decreased risk of failure (p=0.0043). Remaining parameters were not statistically significant.
Long-term IOP control following treatment of glaucoma surgery associated endophthalmitis was maintained in 41% of eyes with or without medical therapy. About half of the cohort required additional glaucoma surgery for IOP control. Age greater than 65 years and black race were associated with increased risk of failure while phakic lens was associated with decreased risk of failure.
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