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Delayed-onset endophthalmitis associated with conjunctival filtering blebs

T A Kangas1, D S Greenfield, H W Flynn

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

Ophthalmology
|May 1, 1997
PubMed
Summary

Delayed-onset endophthalmitis following filtering blebs is a concern, often caused by Streptococcal species. Treatment outcomes show moderate visual acuity, generally worse than acute cases.

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Area of Science:

  • Ophthalmology
  • Infectious Diseases

Background:

  • Conjunctival filtering blebs are used post-glaucoma surgery.
  • Delayed-onset endophthalmitis can occur months after bleb formation.
  • Antimetabolite use, like mitomycin C, may increase risk.

Purpose of the Study:

  • To investigate causative organisms in delayed endophthalmitis.
  • To analyze treatment strategies for bleb-associated endophthalmitis.
  • To evaluate visual acuity outcomes in affected patients.

Main Methods:

  • Retrospective review of 32 patients with bleb-associated endophthalmitis.
  • Diagnosis made at least 1 month post-surgery.
  • Exclusion of bleb infections without intraocular involvement.

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Main Results:

  • Streptococcal species were the most common cause (47%).
  • Intraocular antibiotics were administered to 30 patients.
  • 47% of patients achieved visual acuity of 20/400 or better.
  • Outcomes were worse for Streptococcal infections compared to others.

Conclusions:

  • Delayed endophthalmitis from filtering blebs remains a significant issue.
  • Mitomycin C use is linked to increased risk.
  • Visual outcomes are generally poorer than in acute endophthalmitis post-cataract surgery.