Treatment of Bleb Infection After Glaucoma Surgery

Brown, Reay H.; Yang, Lucy H.; Walker, Stanley D.; Lynch, Mary G.; Martinez, Luis A.; Wilson, Louis A.

doi:10.1001/archopht.1994.01090130067019

Cited by 75 publications

(37 citation statements)

References 8 publications

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“…1 Inhibition of wound healing through antiproliferative drugs is only partially successful and often complicated by avascular filtrating blebs, uncontrolled fluid leakage, and increased risk of infections. [2][3][4][5] Cyclodiode treatment is perhaps regarded as the "standard treatment" for many of such cases. However, cyclodestructive treatment has a narrow therapeutic window in many cases.…”

mentioning

confidence: 99%

Retinectomy for treatment of intractable glaucoma: long term results

Joussen

Walter²,

Jonescu-Cuypers³

et al. 2003

British Journal of Ophthalmology

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Aim: To report long term efficacy and complications of retinectomy as an intraocular pressure lowering procedure for intractable glaucoma. Methods: This was a consecutive interventional case series. In 44 consecutive eyes (39 patients, 22 men and 17 women) retinectomy was performed to lower the intraocular pressure (IOP) in patients with uncontrolled IOP (>35 mm Hg for more than 4 months) despite conventional filtering surgery and drug treatment. Pars plana vitrectomy was performed and the peripheral retina was surgically excised to various degrees. The procedure was concluded by an intraocular gas tamponade of 20% C 3 F 8 . Included were patients with neovascular glaucoma (12 eyes), infantile and juvenile glaucoma (three eyes), secondary glaucoma due to aphakia (13 eyes), severe ocular trauma (seven eyes), uveitis (seven eyes), and glaucoma in Ehlers-Danlos syndrome (two). Results: All patients underwent successful surgical retinectomy. All patients were followed for 5 years. Mean postoperative IOP after 4 years was 15.7 (SD 9.4) mm Hg, representing a decrease of IOP by 61% compared to the preoperative level (41.2 (9.4) mm Hg). In 52.3% of eyes long term regulation of IOP could be achieved without complications. Retinectomy was least effective in neovascular glaucoma because of central retinal vein occlusion (CRVO). Eyes with glaucoma secondary to uveitis showed a tendency towards low IOP levels with subsequent phthisis bulbi. The initial visual acuity of all patients was lower than 20/50 (mean 1.8 (0.8) logMAR) in the treated eye. Final visual acuity was 2.3 (0.6) logMAR. 21 out of 44 cases developed retinal complications (retinal detachment or proliferative vitreoretinopathy (PVR)) after surgery, requiring silicone tamponade in 11 eyes (52%) either for persistent low IOP or for PVR. Nine eyes developed phthisis, seven of which were enucleated during the follow up. Conclusions: Long term results after retinectomy demonstrate its efficacy in otherwise intractable glaucoma. Efficacy and safety of retinectomy are dependent on the underlying disease.

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confidence: 99%

Retinectomy for treatment of intractable glaucoma: long term results

Joussen

Walter²,

Jonescu-Cuypers³

et al. 2003

British Journal of Ophthalmology

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“…[16][17][18][19] One of the most serious complications after glaucoma filtering surgery is infection. This may represent a limited form or early stage of endophthalmitis.…”

Section: Discussionmentioning

confidence: 99%

A review of trabeculectomies at a Nigerian teaching Hospital

Adegbehingbe

Majemgbasan²

2010

Ghana Medical Journal

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SUMMARYBackground: Trabeculectomy is the commonest surgical procedure for glaucoma. The outcome of trabeculectomy in the treatment of all types of glaucoma over a 4-year period in a Nigerian population was reviewed. Objective: To determine the surgical rate and effectiveness of trabeculectomy in lowering of intra ocular pressure (IOP) and preservation of visual acuity. Methods: Retrospective review of all trabeculectomies (TEs) done at the Obafemi Awolowo University Teaching Hospital, Ile-Ife between January 1999 and December 2002. The outcome of trabeculectomy was correlated with the biomicroscopic appearance of the filtering bleb, visual acuity and IOP levels. Descriptive statistics were applied to the data. Results: Of the 647 glaucoma patients only fifty-three (8.2%), 34 males and 19 females, had trabeculectomy done during the study period. Seventy-two consecutive eyes of these 53 Nigerian patients were operated upon. Majority, 63 (87.5%) were in the primary glaucoma group of which 46 (63.9%) were open angle glaucoma type. Nine eyes (12.5%) belonged to the secondary glaucoma group (neovascular, uveitic and traumatic angle recession). Successful control of intra-ocular pressure with medical therapy was recorded only in 13.9% of the patients. The mean pre-operative and first post-operative day IOP were 32.5+/-6.2mmHg and 10.6+/-2.3mmHg respectively. Mean post-op IOP at 3 months and one year were 14.6+/-4.2mmHg, and 13.5+/-5.8mmHg respectively. One year after surgery 34 eyes (61.8%) had intraocular pressure (IOP) of 20mm Hg or less without glaucoma medication. Hyphema 11 (15.3%) was the commonest post-operative complication documented. Conclusions: Surgical intervention in the management of glaucoma, especially trabeculectomy is not commonly done in this Teaching Hospital. IOP control with medication alone is not adequate in the long term. A significant proportion of the eyes (61.8%) had complete success in IOP control following trabeculectomy.

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“…A incidência de infecções relacionadas à presença de uma ampola filtrante tem aumentado preocupantemente com o uso dos antimitóticos (10,12) , dada a maior fragilidade em decorrência de sua exuberância, avascularidade e fragilidade parietal, que a tornam mais suscetível a vazamentos (7)(8)(9)(10)(11) e infecções (13) . A infecção, numa fase inicial, se restringe à ampola filtrante, o que é conhecido na literatura anglo-saxônica como "blebitis", para, depois, se estender à câmara anterior (endoftalmite) e, por fim, envolver também o segmento posterior e, até mesmo, estruturas orbitárias, configurando uma panoftalmite.…”

Section: Discussionunclassified

Panoftalmite tardia após trabeculectomia com mitomicina C

Silva¹,

Carlier²,

Silva³

2010

Rev. bras.oftalmol.

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RESUMOInfecção intraocular é a mais dramática e temível complicação após uma trabeculectomia, com sequelas anatômicas significativas e grave comprometimento funcional, por vezes irreversíveis. Trata-se no presente caso de um paciente do sexo masculino, portador de glaucoma congênito, submetido à trabeculectomia bilateral aos 13 anos de idade, e uma segunda trabeculectomia com mitomicina C aos 32 anos no olho direito (OD), que se apresentou 8 anos após o procedimento com endoftalmite neste olho. Após tratamento anti-inflamatório e antibioticoterápico, tópico e intravítreo, intensivos, o processo foi controlado, restando um olho hipotrófico e amaurótico com catarata e descolamento de retina totais.

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Treatment of Bleb Infection After Glaucoma Surgery

Cited by 75 publications

References 8 publications

Retinectomy for treatment of intractable glaucoma: long term results

Retinectomy for treatment of intractable glaucoma: long term results

A review of trabeculectomies at a Nigerian teaching Hospital

Panoftalmite tardia após trabeculectomia com mitomicina C

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