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Alejandro Saint-Jean, Elena Bitrian, Carolina Vazquez, Joseph Caprioli; Prevalence And Risk Factors Of Bleb Related Infections In A 20-year Period. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2499.
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To evaluate the frequency and course of bleb-related infections after trabeculectomy including blebitis and endophthalmitis in a 20-year period
Retrospective chart review evaluating seven hundred and four patients undergoing filtration surgery from May 1998 to January 2011 by a single surgeon (J.C.). One thousand and forty five surgeries performed in nine hundred and ninety two eyes were analyzed. Data recorded included date of surgery, patient’s age, systemic disease, race, laterality, type of complication, type of glaucoma, prior laser trabeculoplasty, prior filtration surgery, limbus or fornix base, use of antimetabolites, pre-trabeculectomy VA, pre-trabeculectomy IOP, pre-trabeculectomy medication, pre-complication VA, pre-complication IOP, date of complication, complication IOP, complication VA, leakage, culture, treatment, final VA and final IOP.
: A total of 8 bleb-related infections were found of which 6 were blebitis and 2 endophthalmitis (0.77%). They occurred at a mean of 46.2 months after surgery. Four were in Caucasians, 2 in Asians, 1 in a Black patient and one in a Hispanic patient. The mean age of surgery for the infected group was 69 years. Mytomicin C was used in all cases. In the complicated group all eyes had cystic avascular blebs and bleb leaks were seen in 6 of the 8 cases. Final VA remained unaffected in 6 of the 8 cases and functional blebs in 6 of the 8 cases
Bleb-related infections remain a very rare complication of glaucoma surgery with a 0.77% rate. When appropriately managed the outcome of these infections is good.
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