Bleb-related infection after primary trabeculectomy: medical chart reviews from 1993 to 2021.

Autor:	Yang HY; Yuanshan and Suao Branch, Taipei Veterans General Hospital, Yilan, Taiwan.; Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan.; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan., Chi SC; Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan., Ko YC; Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan., Chen MJ; Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan.; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan., Kuang TM; Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan.; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.; Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan., Chang YF; Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan.; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan., Liu CJ; Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan jlliu@vghtpe.gov.tw.; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Jazyk:	angličtina
Zdroj:	The British journal of ophthalmology [Br J Ophthalmol] 2023 Dec 18; Vol. 108 (1), pp. 58-64. Date of Electronic Publication: 2023 Dec 18.
DOI:	10.1136/bjo-2022-321429
Abstrakt:	Background: To investigate the incidence of and risk factors for bleb-related infection (BRI) in patients who underwent mitomycin C-augmented primary trabeculectomy. Methods: We reviewed the medical charts of consecutive patients who had received primary trabeculectomy in Taipei Veterans General Hospital. We recorded the demographic and clinical characteristics of patients before, during and after surgery. Furthermore, we recorded the time interval between surgery and infection onset, clinical manifestations and visual outcomes of patients with BRI. The cumulative incidence of BRI was estimated using the Kaplan-Meier method. A Cox proportional hazards model was used to explore factors associated with BRI. Results: In total, 1663 eyes were postoperatively followed up for 94.57±65.23 months. The cumulative incidence of BRI was 1.86 per 1000 person-years during the 28-year follow-up period: 24 (1.44%) patients developed BRI and 6 (0.36%) patients additionally developed endophthalmitis. A multivariate analysis revealed a significant association of BRI with wound manipulation, high myopia and hyperlipidaemia. Patients younger than 60 years were more likely to receive wound manipulation than their elderly counterparts (<0.001). One year after BRI, the best corrected visual acuity of the eyes with blebitis did not change significantly, whereas that of the eyes with endophthalmitis worsened significantly. Conclusion: Risk factors for BRI after trabeculectomy include wound manipulation, high myopia and hyperlipidaemia. Considering myopia is highly prevalent throughout the world and is a risk factor for glaucoma, the lifelong risk of BRI after trabeculectomy in eyes with high myopia warrants the attention of ophthalmologists. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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