Late onset endophthalmitis associated with filtering blebs.

Area of Science:

• Ophthalmology
• Infectious Diseases

Background:

• Filtering blebs are surgical creations to manage glaucoma.
• Late-onset endophthalmitis, occurring months to years after surgery, poses a significant risk.

Purpose of the Study:

• To analyze the clinical characteristics, microbiology, and outcomes of late-onset endophthalmitis in patients with filtering blebs.
• To differentiate the microbial spectrum from early postoperative endophthalmitis.

Main Methods:

• Retrospective review of 36 patients with late-onset endophthalmitis and filtering blebs.
• Culture of aqueous and/or vitreous humor for microbial identification.
• Assessment of visual outcomes and contributing factors.

Main Results:

• Endophthalmitis onset ranged from 4 months to 60 years post-bleb formation.
• 83% of cases were culture-positive, with Streptococci (57%) and Hemophilus influenzae (23%) being the most common pathogens.
• Visual outcomes were generally poor, attributed to organism virulence.

Conclusions:

• Endophthalmitis is a long-term risk following filtering bleb creation.
• The causative organisms and clinical course differ significantly from early postoperative endophthalmitis.
• Management strategies should consider the unique microbiologic profile and delayed onset.