Bleb‐associated endophthalmitis: Proportion, presentation, management and outcomes in Victoria, Australia

Autor: Nathan M. Kerr, Catherine M Green, Myra B McGuinness, Hye Jin Kwon, Jonathan G Crowston, Himeesh Kumar
Rok vydání: 2019
Předmět:
Male
0301 basic medicine
Intraocular pressure
medicine.medical_specialty
Visual acuity
Victoria
genetic structures
medicine.medical_treatment
Vision Disorders
Visual Acuity
Glaucoma
Trabeculectomy
Exfoliation Syndrome
Eye Infections
Bacterial
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Endophthalmitis
Risk Factors
medicine
Humans
Glucocorticoids
Intraocular Pressure
Aged
Retrospective Studies
Aged
80 and over
Bacteria
business.industry
Incidence
Incidence (epidemiology)
Retrospective cohort study
Middle Aged
Eye infection
medicine.disease
eye diseases
Anti-Bacterial Agents
Surgery
Ophthalmology
Treatment Outcome
030104 developmental biology
030221 ophthalmology & optometry
Female
sense organs
medicine.symptom
Glaucoma
Angle-Closure
business
Glaucoma
Open-Angle
Zdroj: Clinical & Experimental Ophthalmology.
ISSN: 1442-9071
1442-6404
DOI: 10.1111/ceo.13477
Popis: Importance Bleb-associated endophthalmitis is a potentially vision-threatening complication of trabeculectomy. With improvements in surgical technique and changing patterns of intraoperative antimetabolite use, a re-evaluation of the incidence of bleb-associated endophthalmitis is warranted. Background To investigate changes in the incidence, presentation, management and outcomes of bleb-associated endophthalmitis between 1997 and 2015 in Victoria, Australia. Design A retrospective cohort analysis. Participants Consecutive cases of bleb-associated endophthalmitis managed at the Royal Victorian Eye and Ear Hospital (RVEEH) between 1997 and 2015. Methods Medical record review of consecutive cases of bleb-associated endophthalmitis and statistical analysis were performed. Main outcome measures Visual acuity, including loss of light perception, intraocular pressure, and need for further surgery. Results Sixty-seven eyes with bleb-associated endophthalmitis (BAE) were identified. Of these, 41 had trabeculectomy performed in Victoria during the study period, over which time 11 129 trabeculectomies were performed. The proportion of BAE was stable over time (0.4%). The mean age at presentation was 73.7 ± 12.1 years old and the majority of patients were Caucasian (79.1%). The mean duration between glaucoma filtration surgery and the development of bleb-associated endophthalmitis was 3 years (Interquartile Range = 0.4-6.0 years). The cultures were positive in 71.6% of cases. Approximately 1 in 8 patients required enucleation. The final visual acuity was poor with a Snellen Visual Acuity (VA) of 6/60 or worse in two-thirds of patients. Conclusions and relevance Bleb-associated endophthalmitis is an uncommon complication following glaucoma filtration surgery. The proportion has remained stable over time. Visual outcomes remain poor.
Databáze: OpenAIRE
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