Abstract | PURPOSE: DESIGN: Retrospective case series. METHODS: RESULTS: Twenty-four eyes were diagnosed with bleb-related infections; 15 eyes were found to have blebitis and 9 eyes presented with endophthalmitis during the follow-up period of 5.4 ± 3.5 years (mean ± standard deviation). Among 15 eyes with blebitis, 2 eyes developed endophthalmitis under treatment. The Kaplan-Meier estimated incidence of bleb-related infections was 2.0% ± 0.5% (mean ± standard error) at 10 years. A Cox multivariate analysis showed the significant risk factors for a bleb-related infection to be diagnoses of pigmentary glaucoma or juvenile glaucoma, history of bleb leak, intraocular pressure sustained below the target pressure, chronic blepharitis, and the presence of punctal plugs. Surgical bleb revision demonstrated a protective effect against bleb-related infections (P < .01) when risk factors were present. CONCLUSIONS: This large case series with long-term follow-up demonstrates the incidence of bleb-related infections to be less than 2%, and describes the risk factors associated with bleb-related infections. A protective effect of surgical bleb revision was demonstrated. Clinicians should be constantly vigilant for, and patients made aware of, the possibility of bleb-related infections long after trabeculectomy, especially in the presence of identified risk factors.
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Authors | Eun-Ah Kim, Simon K Law, Anne L Coleman, Kouros Nouri-Mahdavi, JoAnn A Giaconi, Fei Yu, Ji-Woong Lee, Joseph Caprioli |
Journal | American journal of ophthalmology
(Am J Ophthalmol)
Vol. 159
Issue 6
Pg. 1082-91
(Jun 2015)
ISSN: 1879-1891 [Electronic] United States |
PMID | 25748577
(Publication Type: Journal Article)
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Copyright | Copyright © 2015 Elsevier Inc. All rights reserved. |
Chemical References |
- Alkylating Agents
- Anti-Bacterial Agents
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Topics |
- Adult
- Aged
- Alkylating Agents
(administration & dosage)
- Anti-Bacterial Agents
(therapeutic use)
- Endophthalmitis
(drug therapy, epidemiology, microbiology)
- Eye Infections, Bacterial
(drug therapy, epidemiology, microbiology)
- Eye Infections, Fungal
(drug therapy, epidemiology, microbiology)
- Female
- Follow-Up Studies
- Glaucoma
(surgery)
- Humans
- Incidence
- Intraocular Pressure
(physiology)
- Male
- Middle Aged
- Reoperation
- Retrospective Studies
- Risk Factors
- Surgically-Created Structures
(microbiology)
- Trabeculectomy
(adverse effects)
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