Sharan Sapna, Trope Graham E, Chipman Mary, Buys Yvonne M
Toronto Western Hospital, University Health Network, Ontario, Canada.
Can J Ophthalmol. 2009 Jun;44(3):279-83. doi: 10.3129/i09-050.
The purpose of this study was to determine the rate and course of blebitis/late endophthalmitis 5-10 years post-filtration surgery and to evaluate risk factors.
Retrospective chart review.
Three hundred fifty consecutive patients undergoing filtration surgery from January 1, 1996, to December 31, 2001, by a single surgeon. Five hundred twenty-one surgeries were evaluated.
Data recorded included patient demographics, systemic disease(s), glaucoma type, left or right eye, date of surgery, last follow-up date, surgical procedure details, postoperative antimetabolite injections, bleb manipulations, bleb leaks and treatment, date of infection, type of infection, pre- and postinfection visual acuity, intraocular pressure (preinfection, during, and postinfection), treatment, and functionality of the bleb after infection. Statistical analysis used for assessment of risk factors included Fisher's exact test and the Student's t test analysis.
There were a total of 5 bleb-related infections (0.96%), 4 blebitis and 1 endophthalmitis, occurring at a mean of 31.3 months after surgery. Three occurred in blacks and 2 in Caucasians. The mean age at surgery for the infected group was 53.5 years compared with 64.7 years for those with no infection. Mitomycin C was used in 4 of the 5 cases compared with in 52% of controls. Four underwent suture lysis. Bleb leaks occurred in 4 cases. The bleb remained functional and vision unchanged in the 4 blebitis cases; however, the endophthalmitis case lost vision and had uncontrolled pressure following the infection.
We report a 0.96% bleb infection rate with a 5.3-year mean follow-up. Bleb leak, black race, and bleb manipulation were risk factors for infection.
本研究旨在确定滤过性手术后5至10年巩膜瓣炎/晚期眼内炎的发生率及病程，并评估危险因素。
回顾性病历审查。
1996年1月1日至2001年12月31日期间由同一位外科医生连续进行滤过性手术的350例患者。共评估了521例手术。
记录的数据包括患者人口统计学资料、全身性疾病、青光眼类型、左眼或右眼、手术日期、最后随访日期、手术操作细节、术后抗代谢药物注射、巩膜瓣处理、巩膜瓣渗漏及处理、感染日期、感染类型、感染前后视力、眼压（感染前、感染期间及感染后）、治疗以及感染后巩膜瓣的功能。用于评估危险因素的统计分析包括Fisher精确检验和学生t检验分析。
共有5例与巩膜瓣相关的感染（0.96%），4例巩膜瓣炎和1例眼内炎，平均发生在术后31.3个月。3例发生在黑人患者，2例发生在白人患者。感染组手术时的平均年龄为53.5岁，未感染组为64.7岁。5例中有4例使用了丝裂霉素C，而对照组为52%。4例进行了缝线松解。4例发生巩膜瓣渗漏。4例巩膜瓣炎患者的巩膜瓣仍保持功能且视力未变；然而，眼内炎患者感染后视力丧失且眼压失控。
我们报告平均随访5.3年的巩膜瓣感染率为0.96%。巩膜瓣渗漏、黑人种族和巩膜瓣处理是感染的危险因素。
