Bleb-related ocular infection in children after trabeculectomy with mitomycin C.
OBJECTIVE
The purpose of the study is to report the clinical course of bleb-related ocular infection in children after trabeculectomy with adjunctive mitomycin C.


METHODS
The study design was a retrospective review of all patients with a diagnosis of bleb-related ocular infection after trabeculectomy with adjunctive mitomycin C.


METHODS
Three children were identified in whom late postoperative bleb-related ocular infection developed.


METHODS
Treatment consisted of vitreous biopsy with intravitreous antibiotic and corticosteroid injection and/or bleb culture with topical and intravenous antibiotic administration.


METHODS
Visual acuity and intraocular pressure were measured.


RESULTS
Bleb-related ocular infection developed an average of 16.7 +/- 10.9 months after trabeculectomy (range, 4-23 months). The mean age at presentation was 7.0 +/- 2.6 years (range, 4-10 years). Vitreous cultures were positive for staphylococci in two cases. A bleb culture from the third case also grew staphylococcus. All of the children recovered their initial vision after treatment of infection. However, one lost six lines of vision after a subsequent retinal detachment. Additional glaucoma surgery was required in one patient.


CONCLUSIONS
Late bleb-related ocular infection may occur in children after trabeculectomy with mitomycin C and is characterized by abrupt onset, bleb infiltration, and rapid progression. Despite early preservation of vision after treatment of infection, significant late visual loss can occur.
Waheed
S
S
Department of Ophthalmology, The New York Eye and Ear Infirmary, New York 10003, USA.
Ritterband
D C
DC
Greenfield
D S
DS
Liebmann
J M
JM
Sidoti
P A
PA
Ritch
R
R
D000900:Anti-Bacterial Agents; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D017024:Chemotherapy, Adjuvant; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D009877:Endophthalmitis / Q000188:drug therapy / Q000382:microbiology*; D015818:Eye Infections, Bacterial / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D005901:Glaucoma / Q000151:congenital / Q000601:surgery; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D016685:Mitomycin / Q000008:administration & dosage; D010030:Ostomy / Q000009:adverse effects*; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000209:etiology*; D013211:Staphylococcus aureus / Q000302:isolation & purification; D014130:Trabeculectomy / Q000009:adverse effects*; D014792:Visual Acuity; D014822:Vitreous Body / Q000382:microbiology
D000900:Anti-Bacterial Agents; D000903:Antibiotics, Antineoplastic; D016685:Mitomycin