Risk factors for bleb-related infection following trabeculectomy surgery: ocular surface findings-a case-control
Poornima A Rai1, Keith Barton1,2, Ian E Murdoch2
1NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital, London, UK.
The British Journal of Ophthalmology
|April 13, 2017
Summary
Chronic blepharitis is a significant risk factor for bleb-related infection after trabeculectomy surgery. Managing eyelid disease before surgery may reduce the risk of this serious complication.
Area of Science:
- Ophthalmology
- Surgical Complications
- Ocular Surface Disease
Background:
- Bleb-related infection (BRI) is a severe complication following trabeculectomy, a glaucoma surgery.
- The incidence of BRI may have increased with the use of antimetabolites like mitomycin C.
Purpose of the Study:
- To identify ocular risk factors for BRI, focusing on ocular surface parameters.
- To investigate the association between BRI and factors such as antimetabolite use, surgical technique, age, dry eyes, and chronic blepharitis.
Main Methods:
- A case-control study design was employed.
- Data were collected through patient record reviews, questionnaires on ocular surface symptoms, and detailed clinical examinations of the eyelids, ocular surface, and tear film.
Main Results:
- Chronic blepharitis was identified as a major risk factor for BRI (OR 16.3, p=0.016).
- No significant increased risk of BRI was associated with antimetabolite use (p=0.38), surgical technique (p=0.38), age (p=0.32), or dry eyes (p=0.13).
Conclusions:
- Eyes with chronic blepharitis have a higher risk of developing BRI post-trabeculectomy.
- Pre-operative management of blepharitis or alternative surgical options like shunts may be advisable to minimize BRI risk.
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