Treatment of bleb infection after glaucoma surgery.
OBJECTIVE
To assess the history, clinical course, and response to treatment of 14 patients with a bleb infection (blebitis) following glaucoma surgery.


METHODS
Retrospective study.


METHODS
A university referral center in Atlanta, Ga.


METHODS
Fourteen patients developed a bleb infection that ranged from 1 month to 22 years after glaucoma surgery. Infections were characterized by pain, a whitened bleb surrounded by intense conjunctival injection, marked anterior chamber reaction (hypopyon in six eyes), and a clear vitreous. Before infection, most blebs were described as thin. The results of Seidel's test were positive in six patients, and most patients had a low intraocular pressure without the use of any glaucoma medication.


METHODS
Treatment consisted of hospitalization, intravenous antibiotic therapy, and hourly topical fortified cefazolin sodium and gentamicin sulfate.


RESULTS
The visual acuity in most patients improved to the level before the bleb infection, with only three eyes losing 2 or more lines of vision.


CONCLUSIONS
Bleb infection without vitreous involvement (blebitis) may be a precursor of endophthalmitis. With aggressive treatment, bleb infection appears to have a much better prognosis for visual recovery than endophthalmitis.
Brown
R H
RH
Department of Ophthalmology, Emory University School of Medicine, Atlanta, Ga.
Yang
L H
LH
Walker
S D
SD
Lynch
M G
MG
Martinez
L A
LA
Wilson
L A
LA
D000293:Adolescent; D000328:Adult; D000368:Aged; D002437:Cefazolin / Q000008:administration & dosage / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D015818:Eye Infections, Bacterial / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage / Q000627:therapeutic use; D005901:Glaucoma / Q000601:surgery*; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions; D012189:Retrospective Studies; D012599:Sclerostomy / Q000009:adverse effects; D013530:Surgical Wound Infection / Q000188:drug therapy* / Q000209:etiology; D014130:Trabeculectomy / Q000009:adverse effects
D005839:Gentamicins; D009883:Ophthalmic Solutions; D002437:Cefazolin