Bleb-associated endophthalmitis treated by sclera patch graft, vitrectomy and endoscopic cyclophotocoagulation

Area of Science:

• Ophthalmology
• Surgical Innovation

Background:

• Bleb-associated endophthalmitis (BAE) is a severe complication following trabeculectomy.
• Current treatment protocols for BAE are not well-defined, leading to poor outcomes.
• This study addresses the need for effective BAE management strategies.

Purpose of the Study:

• To introduce a novel combined surgical procedure for BAE treatment.
• To evaluate the efficacy and outcomes of this new combined operation.

Main Methods:

• A cohort of nine patients diagnosed with BAE was included.
• The combined surgical approach involved pars plana vitrectomy (PPV), sclera patch graft (SPG), and endoscopic cyclophotocoagulation (ECP).

Main Results:

• Complete resolution of endophthalmitis was achieved in all patients within 18-24 months.
• Useful visual acuity was preserved in 7 out of 9 patients.
• Intraocular pressure (IOP) was successfully controlled postoperatively in 8 patients; one required an additional procedure.

Conclusions:

• The combined PPV, SPG, and ECP surgery is an effective treatment for BAE.
• SPG and vitrectomy are crucial for controlling the infection.
• ECP plays a vital role in managing postoperative intraocular pressure.