April 2009
Volume 50, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2009
Delayed-Onset Bleb-Associated Endophthalmitis: Causative Organisms, Antibiotic Sensitivities, and Visual Acuity Outcomes (1996-2008)
Author Affiliations & Notes
  • T. Leng
    Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida
  • D. Miller
    Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida
  • H. W. Flynn, Jr.
    Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida
  • S. J. Gedde
    Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida
  • Footnotes
    Commercial Relationships  T. Leng, None; D. Miller, None; H.W. Flynn, Jr., None; S.J. Gedde, None.
  • Footnotes
    Support  Funded in part by Research to Prevent Blindness
Investigative Ophthalmology & Visual Science April 2009, Vol.50, 171. doi:
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      T. Leng, D. Miller, H. W. Flynn, Jr., S. J. Gedde; Delayed-Onset Bleb-Associated Endophthalmitis: Causative Organisms, Antibiotic Sensitivities, and Visual Acuity Outcomes (1996-2008). Invest. Ophthalmol. Vis. Sci. 2009;50(13):171.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To report the clinical features, causative organisms, antibiotic sensitivities, and visual acuity outcomes in patients with delayed-onset bleb-associated endophthalmitis.

Methods: : Retrospective consecutive case series. Patients who were treated at the Bascom Palmer Eye Institute for delayed-onset bleb-associated endophthalmitis between January 1, 1996 through July 1, 2008 were included in this study.

Results: : A total of 60 eyes with delayed-onset bleb-associated endophthalmitis were identified in this 12.5 year period. An anti-fibrotic agent (including 5-flurouracil or mitomycin-C) was used in 45 (75%) of the eyes. At presentation, 45 (75%) had evidence of a bleb leak. The most common causative organisms were Streptococcus species in 17 (28%) eyes and Staphylococcus species in 16 (27%) eyes. All gram-positive isolates were sensitive to vancomycin. Twelve (20%) eyes eventually underwent enucleation or evisceration secondary to pain and/or poor vision. Final visual acuities in the initial tap/inject group (n = 37) versus the initial vitrectomy group (n = 22) were as follows: ≥20/40 (19% versus 5%), 20/50 to 20/400 (49% versus 32%), and <5/200 (32% versus 64%).

Conclusions: : In the current study, many patients had a history of receiving an anti-fibrotic agent during filtering surgery and at presentation showed a bleb leak. Streptococcus and Staphylococcus species were the most common causative organisms. Despite successful treatement of the infection, visual outcomes were generally poor.

Keywords: endophthalmitis • bacterial disease 
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