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Abstract #6566 Published in IGR 3-2
Management of blebitis by members of the American Glaucoma Society: a survey
Reynolds AC; Skuta GL; Monlux R; Johnson JJournal of Glaucoma 2001; 10: 340-347
PURPOSE: To investigate the practice patterns among glaucoma subspecialists in the American Glaucoma Society regarding the management of blebitis. METHODS: An anonymous survey incorporating 14 questions regarding the management of blebitis was mailed to all current active American Glaucoma Society members, including provisional members, in October 1999. RESULTS: A total of 319 physicians received the survey, and 204 members (64%) returned it. Sixty-nine percent of respondents do not ask their patients with functioning blebs to use topical antibiotics at home for early symptoms of blebitis. Thirty-four percent never, or almost never, obtain conjunctival cultures at the onset of isolated blebitis, whereas 44% always or usually do. Fifty-one percent prescribe a topical fluoroquinolone alone as the initial empirical treatment of isolated blebitis. Twenty-three percent use a fluoroquinolone in combination with one or two other antibiotics. Twenty-one percent choose a combination of fortified topical agents, usually including a fortified aminoglycoside, vancomycin, or cephalosporin. Thirty-one percent use fortified agents in some combination with or without a fluoroquinolone. Five percent prescribe some other single agent alone. Only 6% routinely use an oral antibiotic in cases of blebitis. Sixty-two percent use topical corticosteroids in conjunction with antibiotic treatment. Of these, 68% start them after initial antibiotic treatment is established, or once improvement of blebitis is noted. Fifty-six percent indicated that a moderate or severe anterior chamber reaction, including fibrin, would prompt treatment as a possible endophthalmitis. In a persistently Seidel-positive bleb, 77% generally attempt surgical bleb revision. CONCLUSIONS: Methods of management of blebitis differ among members of the American Glaucoma Society. Treatment recommendations generated from randomized clinical trials are needed.
Dr A.C. Reynolds, The Dean A. McGee Eye Institute, University of Oklahoma College of Medicine, 608 Stanton L. Young Boulevard, Oklahoma City, OK 73104, USA
Classification:
12.8.11 Complications, endophthalmitis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)