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Abstract
Objective: The purpose of this study was to determine the rate and course of blebitis/late endophthalmitis
5–10 years post-filtration surgery and to evaluate risk factors.
Design: Retrospective chart review.
Participants: Three hundred fifty consecutive patients undergoing filtration surgery from January
1, 1996, to December 31, 2001, by a single surgeon. Five hundred twenty-one surgeries
were evaluated.
Methods: Data recorded included patient demographics, systemic disease(s), glaucoma type,
left or right eye, date of surgery, last follow-up date, surgical procedure details,
postoperative antimetabolite injections, bleb manipulations, bleb leaks and treatment,
date of infection, type of infection, pre- and postinfection visual acuity, intraocular
pressure (preinfection, during, and postinfection), treatment, and functionality of
the bleb after infection. Statistical analysis used for assessment of risk factors
included Fisher's exact test and the Student's t test analysis.
Results: There were a total of 5 bleb-related infections (0.96%), 4 blebitis and 1 endophthalmitis,
occurring at a mean of 31.3 months after surgery. Three occurred in blacks and 2 in
Caucasians. The mean age at surgery for the infected group was 53.5 years compared
with 64.7 years for those with no infection. Mitomycin C was used in 4 of the 5 cases
compared with in 52% of controls. Four underwent suture lysis. Bleb leaks occurred
in 4 cases. The bleb remained functional and vision unchanged in the 4 blebitis cases;
however, the endophthalmitis case lost vision and had uncontrolled pressure following
the infection.
Conclusions: We report a 0.96% bleb infection rate with a 5.3-year mean follow-up. Bleb leak,
black race, and bleb manipulation were risk factors for infection.
Résumé
Objet: Établissement du taux et des suites de la blébite, endophtalmie tardive 5 à 10 ans
après une chirurgie de filtration, et évaluation des facteurs de risque.
Nature: Examen rétrospectif des dossiers.
Participants: Trois cent cinquante patients consécutifs ayant subi une chirurgie de filtration
entre le 1er janvier 1996 et le 31 décembre 2001, par le même chirurgien. Cinq cent vingt et une
chirurgies ont été évaluées.
Méthodes: Les données comprenaient la démographie des patients, les maladies systémiques, les
types de glaucome, l’œil droit ou gauche, la date de la chirurgie, la date du dernier
suivi, les détails de la procédure chirurgicale, les injections d’antimétabolites
post-opératoires, les manipulations de la bulle, fuites de la bulle et traitement,
la date de l’infection, le genre d’infection, l’acuité visuelle avant et après l’infection,
la pression intraoculaire (avant, pendant et après l’infection), le traitement et
la fonctionnalité de la bulle après l’infection. L’analyse statistique utilisée pour
l’évaluation des facteurs de risque comprenait le test d’exactitude de Fisher et l’analyse
des tests t des étudiants.
Résultats: En tout, 5 infections de la bulle (0,96 %), 4 blébites et 1 endophtalmie survenues
en moyenne 31,3 mois après l’opération. Trois ont affecté des noirs et 2, des blancs.
L’âge moyen du groupe infecté au moment de la chirurgie était de 53,5 ans, comparativement
à 64,7 ans pour ceux qui n’avaient pas l’infection. La mitomycine C a été utilisée
dans 4 cas sur 5, comparativement à 52 % chez les cas témoins. Quatre ont subi une
suturolyse. Quatre ont eu une fuite de la bulle. La bulle est demeurée fonctionnelle
et la vision inchangée dans les quatre cas de blé-bite; cependant, le cas d’endophtalmie
a perdu la vision et eu une pression incontrôlée après l’infection.
Conclusions: Nous faisons état d’un taux de 0,96 % d’infection de la bulle avec un suivi de 5,3
années en moyenne. La fuite de la bulle, la race noire et la manipulation de la bulle
étaient des facteurs de risque d’infection.
Keywords
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Article info
Publication history
Accepted:
January 1,
2009
Received in revised form:
October 24,
2008
Received:
May 1,
2008
Footnotes
aPresented at the Association for Research in Vision and Ophthalmology Annual Meeting in Fort Lauderdale, Fla., May 10, 2007
bThis article has been peer-reviewed.
Identification
Copyright
© 2009 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.
