Bleb complication rates 'fairly constant' after trabeculectomy with MMC

MADISON, Wis. — The rate of occurrence of bleb complications in patients who have undergone trabeculectomy with mitomycin-C is fairly constant over time, according to a large retrospective study. At 5 years, up to 23% of patients might develop bleb-related complications, including bleb leak, blebitis or endophthalmitis.

Isolated bleb leaks seem to be relatively benign, however, as three-quarters resolve with office-based treatment, the study authors said.

Researchers here reviewed the records of 239 eyes of 198 patients. Average follow-up was 2.7 years. Twenty eyes (8%) of 19 patients experienced a bleb leak, and five eyes had an episode of blebitis. Eight eyes experienced endophthalmitis. Twenty-seven eyes of 26 patients had at least one of the complications of a bleb leak, blebitis or endophthalmitis.

The calculated 5-year probability of developing a bleb leak was 17.9%, of developing blebitis 6.3%, and of developing endophthalmitis 2.7%.

In the 242 eyes of 198 patients who underwent 258 trabeculectomies, bleb leaks occurred in 22 (9%). Of those patients, 17 eyes were successfully treated with office-based measures and four required surgical bleb revision.

The study is published in the March issue of Archives of Ophthalmology.