Study details risk factors for blebitis, endophthalmitis after filtration surgery

Can J Ophthalmol. 2009;44(3):279-283.

Bleb leak, bleb manipulation and race were the leading risk factors for infection after filtration surgery for glaucoma management, according to a study.

"The purpose of this study was to determine the rate and course of blebitis/late endophthalmitis 5 to 10 years post-filtration surgery and to evaluate risk factors," the study authors said.

The retrospective study included charts for 350 consecutive patients who underwent filtration surgery between January 1996 and December 2001. Investigators evaluated 521 surgeries.

Some of the primary measures included patient demographics, systemic conditions, glaucoma type and date of surgery, date of final follow-up, rates of injection, bleb manipulation, bleb leak and infection, visual acuity and IOP.

The study results showed five bleb-related infections (0.96%), including four cases of blebitis and one case of endophthalmitis. The infections took place a mean 31.3 months after surgery. Infections were seen in three black patients and two white patients. Mean follow-up was 5.3 years.

Patients in the infected group had a mean age of 53.5 years at the time of surgery, and patients in the non-infected group had a mean age of 64.7 years.

Mitomycin C was used in four of the five cases involving infection and in 52% of controls.

The bleb continued functioning and vision was unchanged in the four blebitis cases. The endophthalmitis case involved loss of vision and uncontrolled pressure after the infection, the authors said.