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Endophthalmitis after filtering surgery with mitomycin

D S Greenfield1, I J Suñer, M P Miller

  • 1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami (Fla) School of Medicine, USA.

Archives of Ophthalmology (Chicago, Ill. : 1960)
|August 1, 1996
PubMed
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Glaucoma filtering surgery with mitomycin increases the risk of bleb-associated endophthalmitis, especially with inferior limbal trabeculectomy. While filtration capacity is maintained, visual outcomes after infection treatment are often poor.

Area of Science:

  • Ophthalmology
  • Glaucoma Surgery
  • Infectious Disease

Background:

  • Glaucoma filtering surgery aims to reduce intraocular pressure.
  • Mitomycin is an antifibrotic agent used to enhance surgical success.
  • Bleb-associated endophthalmitis is a serious complication of filtering surgery.

Purpose of the Study:

  • To determine the incidence of bleb-associated endophthalmitis after glaucoma filtering surgery with mitomycin.
  • To identify the causative organisms and clinical outcomes of this infection.
  • To compare infection rates between different surgical approaches.

Main Methods:

  • Retrospective analysis of 609 eyes undergoing glaucoma filtering surgery with mitomycin.
  • Minimum follow-up of 3 months.

Related Experiment Videos

  • Kaplan-Meier survival analysis to estimate infection incidence.

    • Main Results:

    • The incidence of bleb-associated endophthalmitis was 2.1% (13 eyes).
    • Inferior limbal trabeculectomy had a significantly higher incidence (13%) compared to superior trabeculectomy (1.6%).
    • Streptococcus sanguis and Haemophilus influenzae were the most common pathogens; visual outcomes were generally poor post-treatment.

    Conclusions:

    • Glaucoma filtering surgery with mitomycin is associated with a higher rate of bleb-associated endophthalmitis than surgery without antifibrotic agents.
    • Inferior limbal trabeculectomy poses the greatest risk for infection.
    • Despite maintained filtration, post-infection visual acuity is often compromised.