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Bleb-related endophthalmitis after trabeculectomy with mitomycin C
E J Higginbotham1, R K Stevens, D C Musch
1Department of Ophthalmology, University of Maryland, Baltimore 21201, USA.
Ophthalmology
|April 1, 1996
Summary
Inferior trabeculectomy with mitomycin C (MMC) significantly increases endophthalmitis risk compared to superior approaches. This study highlights the importance of surgical site selection for preventing serious infection after glaucoma surgery.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Infectious Disease
Background:
- Trabeculectomy is a common glaucoma surgery.
- Mitomycin C (MMC) is an antifibrotic agent used adjunctively.
- Filtering blebs are a potential site for infection.
Purpose of the Study:
- To investigate the association between filtering blebs from mitomycin C (MMC)-augmented trabeculectomy and the risk of endophthalmitis.
- To compare the incidence of endophthalmitis based on the surgical site (inferior vs. superior).
Main Methods:
- Retrospective review of 232 trabeculectomies using MMC.
- Data collected included patient demographics, glaucoma type, surgical site, MMC details, bleb leakage, and endophthalmitis occurrence.
- Statistical analysis using Fisher's exact test.
Main Results:
- Overall incidence of bleb-related endophthalmitis was 2.6% in 229 eyes.
- Inferior approach had 8% endophthalmitis rate vs. 1.1% for superior approach (P = 0.02).
- Odds ratio for endophthalmitis with inferior vs. superior MMC trabeculectomy was 7.7.
Conclusions:
- Trabeculectomy with MMC has an endophthalmitis rate comparable to other agents.
- Inferior trabeculectomy with MMC poses a significantly higher risk of bleb-related endophthalmitis.
- Surgical site selection is crucial for mitigating endophthalmitis risk.