Bleb-related endophthalmitis after trabeculectomy with mitomycin C
| Autor: | R K Stevens, T J Bergstrom, G L Skuta, K O Karp, P R Lichter, David C. Musch, Eve J. Higginbotham |
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| Rok vydání: | 1996 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Eye disease Mitomycin Ostomy Glaucoma Trabeculectomy Eye Infections Bacterial Aqueous Humor Endophthalmitis Postoperative Complications Risk Factors Ophthalmology Glaucoma surgery Medicine Humans Aged Retrospective Studies Aged 80 and over Antibiotics Antineoplastic Bacteria business.industry Incidence Mitomycin C Retrospective cohort study Eye infection Middle Aged medicine.disease Surgery Anti-Bacterial Agents Vitreous Body Chemotherapy Adjuvant Female business |
| Zdroj: | Ophthalmology. 103(4) |
| ISSN: | 0161-6420 |
| Popis: | Purpose: To determine whether filtering blebs resulting from adjunctive use of mitomycin C (MMC) leads to an increased risk of endophthalmitis. Methods: The authors retrospectively reviewed the records of 232 consecutive trabeculectomies performed at the W. K. Kellogg Eye Center with adjunctive use of MMC from May 1990 through June 1993. Data obtained from the records included patient age, sex, race, type of glaucoma, site of filtration surgery, concentration and duration of exposure to MMC, presence of early or late bleb leakage, and the occurrence of endophthalmitis. Results: Three patients were lost to follow-up less than 1 month after surgery. A total of 229 eyes of 192 patients (110 women and 82 men) were included in the study. Mean follow-up of patients remaining free of infection was 18.5 ± 10.8 months (range, 1-44 months). The overall incidence of bleb-related endophthalmitis was 2.6%. Endophthalmitis developed in 8% of patients (4 of 50) in whom an inferior approach was used and in 1.1 % (2 of 179) in whom a superior approach was used ( P = 0.02, Fisher's exact test). The estimated odds ratio for the development of endophthalmitis after trabeculectomy with adjunctive MMC for inferior versus superior filtration sites was 7.7. Conclusion: Short-term follow-up of trabeculectomies performed with adjunctive use of MMC demonstrates an overall incidence of endophthalmitis comparable to filtration procedures performed with 5-fluorouracil or without antifibrotic agents. However, inferior trabeculectomy performed with adjunctive MMC carries a significantly increased risk of bleb-related endophthalmitis compared with filters performed superiorly. |
| Databáze: | OpenAIRE |
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