Late-onset blebitis/endophthalmitis: incidence and outcomes with mitomycin C

Abstract

Purpose: To assess the outcomes of patients who had late infections after undergoing filtering surgery with mitomycin C with respect to treatment, resultant vision, and maintenance of intraocular pressure.

Methods: A retrospective review of 233 eyes that underwent trabeculectomy with mitomycin C with or without coincident cataract extraction and intraocular lens insertion from August 1993 to June 1997 was undertaken. Records were examined for postoperative infection occurring at least 6 months after filtering surgery. Age, sex, date, and type of surgery were reviewed and entered into a computerized database.

Results: Bleb infections occurred in 6 of 233 (2.6%) eyes that underwent mitomycin C filtering surgery. Four of these developed endophthalmitis. The average postoperative time until infection was 24.7 months. Two patients had bleb leaks, one of which progressed to endophthalmitis. On resolution of infection, all blebs remained functional, and vision returned to preblebitis acuities in 67%.

Conclusion: Aggressive topical antibiotic therapy with daily observation may be appropriate in selected cases of late-onset blebitis and endophthalmitis. Eyes may continue to have good visual outcomes and functioning filters without need for additional surgery or hospitalization. Early recognition and appropriate management of infections may play a role in these outcomes.