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T. Matsuba, T. Hasegawa, E. Toyoda, Y. Kuwayama; 25-Gauge Transconjunctival Vitrectomy for Bacterial Endophthalmitis With Bleb Infection After Trabeculectomy. Invest. Ophthalmol. Vis. Sci. 2009;50(13):172.
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Bacterial endophthalmitis is the most serious side effect after trabeculectomy. To treat serious cases, conventional vitrectomy reduces the filtering function of the eye with filtering bleb after trabeculectomy. We ingestigated whether transconjunctival vitrectomy for bacterial endophthalmitis after trabeculectomy cures the infection and maintains the function of the filtering bleb after transconjunctival vitrectomy.
We retrospectively investigated 4 eyes of 4 patients who had received transconjanctival vitrectomy for bacterial endophthalmitis with filtering bleb after trabeculectomy from December, 2006 to June, 2007 and were followed up for a period of at least one year after vitrectomy. All cases received transconjunctival micro-incisional vitrectomy with 25-gauge system .
In all cases the infection was completely cured and no eyes needed further treatment for bacterial endophthalmitis. No change to the conventional vitrectomy system was needed with any of the eyes during surgery, and no eyes had any intraoperative complications. The preoperative mean intraocular pressure(IOP) of the eyes was 12.0 mmHg(9~22 mmHg). One scleral port was needed to be sutured in 2 eyes at the end of surgery. The postoperative mean IOP of the eyes was 6.8mmHg(1~12 mmHg). The period from the onset to examination was the same days in 2 eyes, one day in 1 eye,and 2 days in 1 eye. In 3 eyes, the visual acuity improved to the level of acuity prior to the onset of endophthalmitis, but the 1 eye whose period from the onset to examination was two days developed visual impairment. No eyes had aqueous leakage from filtering bleb after vitrectomy, and no eyes needed filtering bleb revision because of IOP elevation after vitrectomy.
25-gauge transconjunctival vitrectomy for bacterial endophthalmitis with bleb infection after trabeculectomy is effective for eyes in the acute phase in curing the infection and maintaining the filtering bleb in the long term. However futher investigation is needed t for eyes in the late phase.
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