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Delayed-onset bleb-associated endophthalmitis: clinical features and visual acuity outcomes
Alice Song1, Ingrid U Scott, Harry W Flynn
1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, Florida 33101, USA.
Ophthalmology
|May 3, 2002
Summary
Delayed-onset bleb-associated endophthalmitis, often caused by Streptococcus and Staphylococcus species, typically results in poor visual outcomes despite treatment. Risk factors include bleb leaks and manipulations following glaucoma filtering surgery.
Area of Science:
- Ophthalmology
- Infectious Diseases
Background:
- Bleb-associated endophthalmitis is a serious complication following glaucoma filtering surgery.
- Delayed-onset cases present unique challenges in diagnosis and management.
Purpose of the Study:
- To investigate clinical factors, causative organisms, treatments, and outcomes of delayed-onset bleb-associated endophthalmitis.
- To analyze visual acuity and intraocular pressure control post-treatment.
Main Methods:
- Retrospective, noncomparative case series of patients treated for bleb-associated endophthalmitis.
- Inclusion criteria: prior glaucoma filtering surgery; exclusion: blebs after cataract extraction.
- Data collected on risk factors, organisms, treatments, visual acuity, and intraocular pressure.
Main Results:
- Common organisms: Streptococcus (31%) and Staphylococcus (22%).
- Mean interval to endophthalmitis: 5.0 years post-surgery.
- Poor visual acuity (<5/200) occurred in 64% of the vitrectomy group and 31% of the tap group.
- 11% of patients required enucleation/evisceration; 11% had uncontrolled intraocular pressure.
Conclusions:
- Streptococcus and Staphylococcus species are primary causes of delayed bleb-associated endophthalmitis.
- Visual outcomes remain generally poor despite effective infection treatment.
- Risk factors such as bleb leaks and manipulations are significant.
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