Rai Poornima A, Barton Keith, Murdoch Ian E
NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital, London, UK.
Department of Genetics, UCL Institute of Ophthalmology, London, UK.
Br J Ophthalmol. 2017 Jul;101(7):868-873. doi: 10.1136/bjophthalmol-2016-309188. Epub 2016 Oct 18.
Bleb-related infection (BRI) is a devastating complication of trabeculectomy surgery. The aim of this study was to identify ocular risk factors for BRI with specific emphasis on ocular surface parameters. It has been suggested that the frequency has increased since the introduction of antimetabolites, particularly mitomycin C.
A case-control study.
A clinical study of BRI following trabeculectomy surgery to investigate risk factors by documenting historical data review from patients records, self-reported questionnaire specific to ocular surface symptoms and a repeat detailed clinical examination of the lid, ocular surface and tear film.
Twenty-eight cases and 31 controls were assessed. The overwhelming risk factor for development of BRI was chronic blepharitis (multivariate analysis OR 16.3 (1.687 to 157.44) p=0.016). No increased risk was identified with the antimetabolite used during trabeculectomy surgery (p=0.38) or the type of conjunctival reflection adopted for surgery (p=0.38). Neither age (p=0.32) nor dry eyes (p=0.13) were identified as risk factors.
An increased risk of BRI was identified in eyes with chronic blepharitis. To minimise the risk of infection following trabeculectomy surgery, it may be advisable to manage the lid disease in these patients prior to performing trabeculectomy surgery or offer an alternative treatment such as a shunt.
RAIQ1001.
滤过泡相关感染（BRI）是小梁切除术的一种严重并发症。本研究旨在确定BRI的眼部危险因素，特别关注眼表参数。有人认为，自抗代谢药物尤其是丝裂霉素C引入以来，其发生率有所增加。
病例对照研究。
一项关于小梁切除术后BRI的临床研究，通过记录患者病历中的历史数据回顾、特定眼表症状的自我报告问卷以及对眼睑、眼表和泪膜的重复详细临床检查来调查危险因素。
评估了28例病例和31例对照。发生BRI的压倒性危险因素是慢性睑缘炎（多变量分析OR 16.3（1.687至157.44），p = 0.016）。小梁切除术期间使用的抗代谢药物（p = 0.38）或手术采用的结膜瓣类型（p = 0.38）均未发现风险增加。年龄（p = 0.32）和干眼（p = 0.13）均未被确定为危险因素。
慢性睑缘炎患者发生BRI的风险增加。为尽量降低小梁切除术后的感染风险，在进行小梁切除术之前对这些患者的眼睑疾病进行处理或提供分流等替代治疗可能是可取的。
RAIQ1001。
