Bleb‐related infection revisited: a literature review

Abstract

ABSTRACT. Bleb-related infection (BRI) is one of the serious complications of glaucoma filtering surgery. This literature review is aimed at the evaluation of recent studies related to BRI. The review presented and discussed risk factors, and clinical and laboratory diagnosis emphasizing advances in diagnostic techniques to detect and distinguish the disease as well as to initiate immediate intensive antibacterial treatment. Clinical features of recognized prognostic factors of visual outcome were also presented. The studies showed that the prognosis of blebitis is usually good, unless infection has progressed to endophthalmitis that would signify a poorer prognosis. Despite prompt and intensive treatment of patients with bleb-related endophthalmitis, the outcomes remain unsatisfactory especially with virulent organisms and low initial visual acuity. It has been recommended that early detection and treatment of risk factors and thorough patient education are indispensable in ensuring best prognosis in post-trabeculectomy patients.

Change in visual acuity and associated risk factors after trabeculectomy with adjunctive mitomycin C

“…Bleb‐related infection was not identified as a risk factor in this study, although previous studies reported bleb‐related infection resulted in visual acuity loss (Yassin ) and our multicentre prospective observational study, the Japan Glaucoma Society Survey of Bleb‐related Infection study, reported that bleb‐related infection, particularly stage III, causes significant visual impairment (Yamamoto et al. ,b).…”

Prevention of Ocular Tenon Adhesion to Sclera by a PDMAA Polymer to Improve Results after Glaucoma Surgery

“…On the one hand, chemical substances, such as mitomycin C or 5‐fluorouracil, can be used to improve the results by reducing scarring reaction . The usage of these substances, however, entails a higher risk for wound healing disorders and severe infections . On the other hand, separating agents such as hyaluronate hydrogel, biodegradable collagen, or expanded polytetrafluoroethylene coatings can be used to separate the scleral flap from the lower part of the sclera to prevent scarring.…”

Chirurgische Möglichkeiten der Glaukomtherapie

“…Durch Änderung des Zugangs (fornixbasiert statt limbusbasiert) wird u. a. auch eine breitflächigere Applikation von Mitomycin C möglich und die Rate zystisch verdünnter avaskulärer Filterkissen (▶ Abb. 1) gesenkt, die häufiger zur Leckage und damit zur Blebitis neigen [10]. Eine Überfiltration mit ihren unerwünschten Nebenwirkungen wie abgeflachter Vorderkammer, Aderhautabhebung und Aderhautfalten mit Visusabfall (▶ Abb.…”