title: Late bleb-related endophthalmitis after trabeculectomy with adjunctive 5-fluorouracil.
abstract: The incidence of late-onset bleb-related endophthalmitis was evaluated retrospectively in 229 consecutive trabeculectomies performed with adjunctive 5-fluorouracil (5-FU) therapy. Mean follow-up was 23.7 +/- 16.3 months (range, 3 to 60 months). Thirteen eyes (5.7%) of 11 patients developed bleb-related endophthalmitis an average of 25.9 +/- 17.4 months (range, 5 to 58 months) after surgery. Infection occurred in 9 of 96 (9.4%) procedures performed from below and in 4 of 133 (3.0%) procedures performed superiorly (P = 0.05, Fisher's exact test). The relative risk of bleb-related endophthalmitis in trabeculectomy from below versus above is 4.0 after adjustment for age and sex (95% confidence interval = 1.1, 14.8). Trabeculectomy with adjunctive 5-FU performed from below carries an increased risk of late bleb-related infection. The incidence of late bleb-related endophthalmitis after 5-FU trabeculectomy appears to be higher than that for trabeculectomy without adjunctive 5-FU injections.
authors.affiliation: Department of Ophthalmology, New York Eye and Ear Infirmary, New York City 10003.
authors.forename: B
authors.initials: B
authors.lastname: Wolner
authors.forename: J M
authors.initials: JM
authors.lastname: Liebmann
authors.forename: J W
authors.initials: JW
authors.lastname: Sassani
authors.forename: R
authors.initials: R
authors.lastname: Ritch
authors.forename: M
authors.initials: M
authors.lastname: Speaker
authors.forename: M
authors.initials: M
authors.lastname: Marmor
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D009877:Endophthalmitis / Q000188:drug therapy / Q000209:etiology*; D015818:Eye Infections, Bacterial / Q000188:drug therapy / Q000209:etiology; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use*; D005500:Follow-Up Studies; D005901:Glaucoma / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007429:Intraocular Pressure / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014130:Trabeculectomy / Q000009:adverse effects*; D014792:Visual Acuity / Q000187:drug effects
chemical_list: D000900:Anti-Bacterial Agents; D005472:Fluorouracil