March 2012
Volume 53, Issue 14
Free
ARVO Annual Meeting Abstract  |   March 2012
Prevalence And Risk Factors Of Bleb Related Infections In A 20-year Period
Author Affiliations & Notes
  • Alejandro Saint-Jean
    Ophthalmology, Hospital Clinic Barcelona, Barcelona, Spain
    Ophthalmology, UCLA/ Jules Stein Eye Institute, Los Angeles, California
  • Elena Bitrian
    Ophthalmology, UCLA/ Jules Stein Eye Institute, Los Angeles, California
  • Carolina Vazquez
    Ophthalmology, UCLA/ Jules Stein Eye Institute, Los Angeles, California
  • Joseph Caprioli
    Ophthalmology, UCLA/ Jules Stein Eye Institute, Los Angeles, California
  • Footnotes
    Commercial Relationships  Alejandro Saint-Jean, None; Elena Bitrian, None; Carolina Vazquez, None; Joseph Caprioli, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 2499. doi:
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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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Abstract

Purpose: : To evaluate the frequency and course of bleb-related infections after trabeculectomy including blebitis and endophthalmitis in a 20-year period

Methods: : 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.

Results: : : 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

Conclusions: : 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.

Keywords: clinical (human) or epidemiologic studies: outcomes/complications • bacterial disease • endophthalmitis 
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