Trabeculectomy associated with 2% incidence of bleb infection at 10 years

Surgical bleb revision showed a protective effect against late-onset bleb-related infections after trabeculectomy in the presence of various risk factors, according to a study.

The retrospective study included 1,959 eyes of 1,423 patients who underwent superiorly located trabeculectomies between 1993 and 2013. All eyes were followed for 1 year or longer. Mean follow-up was 5.4 years.

There was an estimated 2% incidence of bleb-related infections at 10 years.

The interval between bleb surgery and onset of bleb-related infections was 4.6 years.

Bleb-related infections were diagnosed in 24 eyes (1.2%); blebitis was identified in 15 eyes, and blebitis and endophthalmitis were found in nine eyes during the follow-up period.

Two of the 15 eyes with blebitis developed endophthalmitis under treatment.

Significant risk factors for bleb-related infection were diagnoses of pigmentary glaucoma or juvenile glaucoma, history of bleb leak, IOP below the target pressure, chronic blepharitis and punctal plug use.

One hundred fifty-three eyes received one surgical bleb revision, 13 eyes had two revisions, and two eyes had three revisions.

Bleb revision had a significant protective effect against bleb-related infections in light of risk factors (P < .01). – by Matt Hasson

Disclosure: The authors report no relevant financial disclosures.

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Source:

Kim E, et al. Am J Ophthalmol. 2015;doi:10.1016/j.ajo.2015.03.001.