Brown R H, Yang L H, Walker S D, Lynch M G, Martinez L A, Wilson L A
Department of Ophthalmology, Emory University School of Medicine, Atlanta, Ga.
Arch Ophthalmol. 1994 Jan;112(1):57-61. doi: 10.1001/archopht.1994.01090130067019.
To assess the history, clinical course, and response to treatment of 14 patients with a bleb infection (blebitis) following glaucoma surgery.
Retrospective study.
A university referral center in Atlanta, Ga.
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.
Treatment consisted of hospitalization, intravenous antibiotic therapy, and hourly topical fortified cefazolin sodium and gentamicin sulfate.
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.
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.
评估14例青光眼手术后出现滤过泡感染（滤过泡炎）患者的病史、临床病程及治疗反应。
回顾性研究。
佐治亚州亚特兰大的一所大学转诊中心。
14例患者在青光眼手术后1个月至22年出现滤过泡感染。感染的特征为疼痛、滤过泡变白并伴有结膜明显充血、显著的前房反应（6只眼有前房积脓）以及玻璃体清晰。感染前，大多数滤过泡被描述为薄壁。6例患者的Seidel试验结果为阳性，大多数患者在未使用任何青光眼药物的情况下眼压较低。
治疗包括住院、静脉抗生素治疗以及每小时局部应用强化头孢唑林钠和硫酸庆大霉素。
大多数患者的视力恢复到滤过泡感染前的水平，仅有3只眼视力下降2行或更多。
无玻璃体受累的滤过泡感染（滤过泡炎）可能是眼内炎的先兆。积极治疗后，滤过泡感染的视力恢复预后似乎比眼内炎好得多。
