Bleb-related infections and long-term follow-up after trabeculectomy
Purpose Bleb-related infections are serious complications after trabeculectomy. They can be limited to the bleb or disseminate and lead to endophthalmitis. We herein report on all bleb-related infections that have been diagnosed at the Eye Center of the University of Freiburg, Germany, since 1999. M...
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| Veröffentlicht in: | International ophthalmology 2019-03, Vol.39 (3), p.571-577 |
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| creator | Luebke, J. Neuburger, M. Jordan, J. F. Wecker, T. Boehringer, D. Cakir, B. Reinhard, T. Anton, A. |
| description | Purpose
Bleb-related infections are serious complications after trabeculectomy. They can be limited to the bleb or disseminate and lead to endophthalmitis. We herein report on all bleb-related infections that have been diagnosed at the Eye Center of the University of Freiburg, Germany, since 1999.
Methods
We reviewed a total of 1816 consecutive trabeculectomies that were performed at our hospital between the years 1999 and 2014 (353 without and 1463 with intraoperative application of mitomycin C). All bleb-related infections that were diagnosed at our clinic during the same period were included in the analysis. We fitted a Cox proportional hazards model to characterize risk factors for bleb-related infections.
Results
We diagnosed a total of 19 bleb-related infections in this period. Three patients with bleb-related infections that came to our clinic had their trabeculectomy performed elsewhere. The overall percentage of bleb-related infections was 0.1% after 2 years (Kaplan–Meier estimate at median follow-up). Nine eyes suffered from only localized infection of the bleb. Seven eyes developed endophthalmitis. Four infections occurred during the first postoperative month. The median age on the day of diagnosis was 71 years; the median age at surgery was 69 years. In the Cox model, intraoperative application of mitomycin C and a fornix-based conjunctival flap were identified as significant risk factors (hazard ratio: 79.02, 4.69;
p
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| doi_str_mv | 10.1007/s10792-018-0851-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2001067792</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2001067792</sourcerecordid><originalsourceid>FETCH-LOGICAL-c438t-caad235b50c9b93d0b8e901149445ae459e6cb1b830a071248c38f5334cfa2873</originalsourceid><addsrcrecordid>eNp1kE1LxDAQhoMoun78AC9S8OIlOvlqkqOunyB40XNI03TZJW3WpEX890ZWRQRPAzPPvDM8CB0TOCcA8iITkJpiIAqDEgTDFpoRIRmmNYNtNANSCywkkD20n_MKALTU9S7ao5rTWtdyhq6vgm9w8sGOvq2WQ-fduIxDruzQViEOCzz61FddDCG-4Wld2a40qjHZxrspFDr274dop7Mh-6OveoBebm-e5_f48enuYX75iB1nasTO2pYy0QhwutGshUZ5DYRwzbmwngvta9eQRjGwIAnlyjHVCca46yxVkh2gs03uOsXXyefR9MvsfAh28HHKhgIQqGVxUtDTP-gqTmko3xmitVaForxQZEO5FHNOvjPrtOxtejcEzKdis1FsimLzqdhA2Tn5Sp6a3rc_G99OC0A3QC6jYeHTr9P_pn4ADyuFFg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1999867724</pqid></control><display><type>article</type><title>Bleb-related infections and long-term follow-up after trabeculectomy</title><source>SpringerLink (Online service)</source><creator>Luebke, J. ; Neuburger, M. ; Jordan, J. F. ; Wecker, T. ; Boehringer, D. ; Cakir, B. ; Reinhard, T. ; Anton, A.</creator><creatorcontrib>Luebke, J. ; Neuburger, M. ; Jordan, J. F. ; Wecker, T. ; Boehringer, D. ; Cakir, B. ; Reinhard, T. ; Anton, A.</creatorcontrib><description>Purpose
Bleb-related infections are serious complications after trabeculectomy. They can be limited to the bleb or disseminate and lead to endophthalmitis. We herein report on all bleb-related infections that have been diagnosed at the Eye Center of the University of Freiburg, Germany, since 1999.
Methods
We reviewed a total of 1816 consecutive trabeculectomies that were performed at our hospital between the years 1999 and 2014 (353 without and 1463 with intraoperative application of mitomycin C). All bleb-related infections that were diagnosed at our clinic during the same period were included in the analysis. We fitted a Cox proportional hazards model to characterize risk factors for bleb-related infections.
Results
We diagnosed a total of 19 bleb-related infections in this period. Three patients with bleb-related infections that came to our clinic had their trabeculectomy performed elsewhere. The overall percentage of bleb-related infections was 0.1% after 2 years (Kaplan–Meier estimate at median follow-up). Nine eyes suffered from only localized infection of the bleb. Seven eyes developed endophthalmitis. Four infections occurred during the first postoperative month. The median age on the day of diagnosis was 71 years; the median age at surgery was 69 years. In the Cox model, intraoperative application of mitomycin C and a fornix-based conjunctival flap were identified as significant risk factors (hazard ratio: 79.02, 4.69;
p
< 0.01,
p
< 0.01). The whole group showed a reduction of visual acuity in the median from logMAR 0.12 to 0.2. Eyes that suffered from endophthalmitis showed a loss from 0.3 to 0.96, while the localized infections had a reduction from 0.04 to 0.07.
Conclusion
Bleb-related infections are a rare complication following trabeculectomy and can be localized on the bleb or can lead to endophthalmitis, thereby threatening visual acuity. The risks and benefits of mitomycin C-augmented trabeculectomies should be taken into consideration.</description><identifier>ISSN: 0165-5701</identifier><identifier>EISSN: 1573-2630</identifier><identifier>DOI: 10.1007/s10792-018-0851-0</identifier><identifier>PMID: 29426967</identifier><language>eng</language><publisher>Dordrecht: Springer Netherlands</publisher><subject>Acuity ; Complications ; Endophthalmitis ; Eye ; Eye (anatomy) ; Fornix ; Hazards ; Health risks ; Infections ; Medicine ; Medicine & Public Health ; Mitomycin C ; Ophthalmology ; Original Paper ; Reduction ; Risk analysis ; Risk factors ; Statistical models ; Surgery ; Visual acuity</subject><ispartof>International ophthalmology, 2019-03, Vol.39 (3), p.571-577</ispartof><rights>Springer Science+Business Media B.V., part of Springer Nature 2018</rights><rights>International Ophthalmology is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c438t-caad235b50c9b93d0b8e901149445ae459e6cb1b830a071248c38f5334cfa2873</citedby><cites>FETCH-LOGICAL-c438t-caad235b50c9b93d0b8e901149445ae459e6cb1b830a071248c38f5334cfa2873</cites><orcidid>0000-0002-3946-5759</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10792-018-0851-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10792-018-0851-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29426967$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Luebke, J.</creatorcontrib><creatorcontrib>Neuburger, M.</creatorcontrib><creatorcontrib>Jordan, J. F.</creatorcontrib><creatorcontrib>Wecker, T.</creatorcontrib><creatorcontrib>Boehringer, D.</creatorcontrib><creatorcontrib>Cakir, B.</creatorcontrib><creatorcontrib>Reinhard, T.</creatorcontrib><creatorcontrib>Anton, A.</creatorcontrib><title>Bleb-related infections and long-term follow-up after trabeculectomy</title><title>International ophthalmology</title><addtitle>Int Ophthalmol</addtitle><addtitle>Int Ophthalmol</addtitle><description>Purpose
Bleb-related infections are serious complications after trabeculectomy. They can be limited to the bleb or disseminate and lead to endophthalmitis. We herein report on all bleb-related infections that have been diagnosed at the Eye Center of the University of Freiburg, Germany, since 1999.
Methods
We reviewed a total of 1816 consecutive trabeculectomies that were performed at our hospital between the years 1999 and 2014 (353 without and 1463 with intraoperative application of mitomycin C). All bleb-related infections that were diagnosed at our clinic during the same period were included in the analysis. We fitted a Cox proportional hazards model to characterize risk factors for bleb-related infections.
Results
We diagnosed a total of 19 bleb-related infections in this period. Three patients with bleb-related infections that came to our clinic had their trabeculectomy performed elsewhere. The overall percentage of bleb-related infections was 0.1% after 2 years (Kaplan–Meier estimate at median follow-up). Nine eyes suffered from only localized infection of the bleb. Seven eyes developed endophthalmitis. Four infections occurred during the first postoperative month. The median age on the day of diagnosis was 71 years; the median age at surgery was 69 years. In the Cox model, intraoperative application of mitomycin C and a fornix-based conjunctival flap were identified as significant risk factors (hazard ratio: 79.02, 4.69;
p
< 0.01,
p
< 0.01). The whole group showed a reduction of visual acuity in the median from logMAR 0.12 to 0.2. Eyes that suffered from endophthalmitis showed a loss from 0.3 to 0.96, while the localized infections had a reduction from 0.04 to 0.07.
Conclusion
Bleb-related infections are a rare complication following trabeculectomy and can be localized on the bleb or can lead to endophthalmitis, thereby threatening visual acuity. The risks and benefits of mitomycin C-augmented trabeculectomies should be taken into consideration.</description><subject>Acuity</subject><subject>Complications</subject><subject>Endophthalmitis</subject><subject>Eye</subject><subject>Eye (anatomy)</subject><subject>Fornix</subject><subject>Hazards</subject><subject>Health risks</subject><subject>Infections</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mitomycin C</subject><subject>Ophthalmology</subject><subject>Original Paper</subject><subject>Reduction</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Statistical models</subject><subject>Surgery</subject><subject>Visual acuity</subject><issn>0165-5701</issn><issn>1573-2630</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNp1kE1LxDAQhoMoun78AC9S8OIlOvlqkqOunyB40XNI03TZJW3WpEX890ZWRQRPAzPPvDM8CB0TOCcA8iITkJpiIAqDEgTDFpoRIRmmNYNtNANSCywkkD20n_MKALTU9S7ao5rTWtdyhq6vgm9w8sGOvq2WQ-fduIxDruzQViEOCzz61FddDCG-4Wld2a40qjHZxrspFDr274dop7Mh-6OveoBebm-e5_f48enuYX75iB1nasTO2pYy0QhwutGshUZ5DYRwzbmwngvta9eQRjGwIAnlyjHVCca46yxVkh2gs03uOsXXyefR9MvsfAh28HHKhgIQqGVxUtDTP-gqTmko3xmitVaForxQZEO5FHNOvjPrtOxtejcEzKdis1FsimLzqdhA2Tn5Sp6a3rc_G99OC0A3QC6jYeHTr9P_pn4ADyuFFg</recordid><startdate>20190301</startdate><enddate>20190301</enddate><creator>Luebke, J.</creator><creator>Neuburger, M.</creator><creator>Jordan, J. F.</creator><creator>Wecker, T.</creator><creator>Boehringer, D.</creator><creator>Cakir, B.</creator><creator>Reinhard, T.</creator><creator>Anton, A.</creator><general>Springer Netherlands</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7T7</scope><scope>7TK</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3946-5759</orcidid></search><sort><creationdate>20190301</creationdate><title>Bleb-related infections and long-term follow-up after trabeculectomy</title><author>Luebke, J. ; Neuburger, M. ; Jordan, J. F. ; Wecker, T. ; Boehringer, D. ; Cakir, B. ; Reinhard, T. ; Anton, A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c438t-caad235b50c9b93d0b8e901149445ae459e6cb1b830a071248c38f5334cfa2873</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Acuity</topic><topic>Complications</topic><topic>Endophthalmitis</topic><topic>Eye</topic><topic>Eye (anatomy)</topic><topic>Fornix</topic><topic>Hazards</topic><topic>Health risks</topic><topic>Infections</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mitomycin C</topic><topic>Ophthalmology</topic><topic>Original Paper</topic><topic>Reduction</topic><topic>Risk analysis</topic><topic>Risk factors</topic><topic>Statistical models</topic><topic>Surgery</topic><topic>Visual acuity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Luebke, J.</creatorcontrib><creatorcontrib>Neuburger, M.</creatorcontrib><creatorcontrib>Jordan, J. F.</creatorcontrib><creatorcontrib>Wecker, T.</creatorcontrib><creatorcontrib>Boehringer, D.</creatorcontrib><creatorcontrib>Cakir, B.</creatorcontrib><creatorcontrib>Reinhard, T.</creatorcontrib><creatorcontrib>Anton, A.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection (Proquest)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>International ophthalmology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Luebke, J.</au><au>Neuburger, M.</au><au>Jordan, J. F.</au><au>Wecker, T.</au><au>Boehringer, D.</au><au>Cakir, B.</au><au>Reinhard, T.</au><au>Anton, A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Bleb-related infections and long-term follow-up after trabeculectomy</atitle><jtitle>International ophthalmology</jtitle><stitle>Int Ophthalmol</stitle><addtitle>Int Ophthalmol</addtitle><date>2019-03-01</date><risdate>2019</risdate><volume>39</volume><issue>3</issue><spage>571</spage><epage>577</epage><pages>571-577</pages><issn>0165-5701</issn><eissn>1573-2630</eissn><abstract>Purpose
Bleb-related infections are serious complications after trabeculectomy. They can be limited to the bleb or disseminate and lead to endophthalmitis. We herein report on all bleb-related infections that have been diagnosed at the Eye Center of the University of Freiburg, Germany, since 1999.
Methods
We reviewed a total of 1816 consecutive trabeculectomies that were performed at our hospital between the years 1999 and 2014 (353 without and 1463 with intraoperative application of mitomycin C). All bleb-related infections that were diagnosed at our clinic during the same period were included in the analysis. We fitted a Cox proportional hazards model to characterize risk factors for bleb-related infections.
Results
We diagnosed a total of 19 bleb-related infections in this period. Three patients with bleb-related infections that came to our clinic had their trabeculectomy performed elsewhere. The overall percentage of bleb-related infections was 0.1% after 2 years (Kaplan–Meier estimate at median follow-up). Nine eyes suffered from only localized infection of the bleb. Seven eyes developed endophthalmitis. Four infections occurred during the first postoperative month. The median age on the day of diagnosis was 71 years; the median age at surgery was 69 years. In the Cox model, intraoperative application of mitomycin C and a fornix-based conjunctival flap were identified as significant risk factors (hazard ratio: 79.02, 4.69;
p
< 0.01,
p
< 0.01). The whole group showed a reduction of visual acuity in the median from logMAR 0.12 to 0.2. Eyes that suffered from endophthalmitis showed a loss from 0.3 to 0.96, while the localized infections had a reduction from 0.04 to 0.07.
Conclusion
Bleb-related infections are a rare complication following trabeculectomy and can be localized on the bleb or can lead to endophthalmitis, thereby threatening visual acuity. The risks and benefits of mitomycin C-augmented trabeculectomies should be taken into consideration.</abstract><cop>Dordrecht</cop><pub>Springer Netherlands</pub><pmid>29426967</pmid><doi>10.1007/s10792-018-0851-0</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-3946-5759</orcidid></addata></record> |
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| subjects | Acuity Complications Endophthalmitis Eye Eye (anatomy) Fornix Hazards Health risks Infections Medicine Medicine & Public Health Mitomycin C Ophthalmology Original Paper Reduction Risk analysis Risk factors Statistical models Surgery Visual acuity |
| title | Bleb-related infections and long-term follow-up after trabeculectomy |
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