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Abstract #49043 Published in IGR 14-1
Changing trends in the incidence of bleb-related infection in trabeculectomy
Rai P; Kotecha A; Kaltsos K; Ruddle JB; Murdoch IE; Bunce C; Barton KBritish Journal of Ophthalmology 2012; 96: 971-975
AIM: To investigate the incidence of late onset bleb-related infection (BRI) following Mitomycin C (MMC) augmented trabeculectomy procedures at a single institution. METHODS: This was a retrospective case series analysis of late onset BRI, defined as either blebitis or endophthalmitis occurring at least 1 month following a glaucoma filtration procedure. Data collected from hospital charts included the position of the conjunctival flap base. Two cohorts were examined: the first a sample of 194 intraoperative MMC augmented trabeculectomies undertaken over a 4-year period from 1993 to 1997, and the second a sample of 764 MMC trabeculectomies performed in a 4-year period between the years 1999 and 2005. RESULTS: A total of 11 cases of BRI (cumulative incidence 5.7%) were identified in the cohort from 1993 to 1997. BRI cases had trabeculectomies performed with a limbus-based conjunctival flap and presented at a median IQR 14.8 (9.4-42.9) months after surgery. In the 1999-2005 cohort, nine cases of BRI were identified (cumulative incidence 1.2%). All these BRI cases had a fornix-based conjunctival flap and presented at a median IQR 19.2 (6.1-44.1) months after trabeculectomy surgery. CONCLUSION: This study found that the incidence of BRI was higher in MMC augmented trabeculectomy shortly after the introduction of MMC, but subsequently reduced to a lower level. While many changes in surgical technique had occurred in the intervening period, the most significant change was from limbus-based to fornix-based conjunctival flap. However, the retrospective nature of the study prevents the authors from concluding that there is a causative relationship between changes in surgical technique and BRI.
Moorfields Eye Hospital NHS Foundation Trust, London, UK.
Full articleClassification:
12.8.11 Complications, endophthalmitis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
