Bleb-related endophthalmitis: Difference between revisions
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==Risk Factors== | ==Risk Factors== | ||
*Bleb leakage (increase the risk of bleb infection 26 fold) | *Bleb leakage (increase the risk of bleb infection 26 fold) | ||
** | **Inappropriate use of of anti-metabolites (such as [[5-fluorouracil|5-fluorouracil (5-FU)]]) | ||
**Inappropriate use of Mitomycn-C (MMC) | |||
***Reduce mucin production | |||
***General conjunctival thinning | |||
** | ***Reduced cellularity | ||
***Avascular bleb | |||
*Conjunctivitis, | |||
*Upper respiratory infection, | |||
*Blepharitis | |||
*Diabetes | |||
*Trabeculectomy alone compared to combined procedure | |||
*Chronic antibiotic use | |||
==Screening== | ==Screening== | ||
| Line 66: | Line 73: | ||
===Prevention=== | ===Prevention=== | ||
====Primary Prevention==== | |||
*Assessment of bleb leakage following tabeculectomy surgery | |||
*Bleb revision with conjunctival advancement to manage avascular leaking blebs (100% success rate) | |||
*Amiotic membrane grafting as a possible alternative to conjunctival advancement (45% success rate) | |||
====Secondary prevention==== | |||
*Bleb revision with conjunctival advancement to manage avascular leaking blebs (100% success rate) | |||
*Amiotic membrane grafting as a possible alternative to conjunctival advancement (45% success rate) | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 19:45, 25 July 2016
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Mehrsefat, M.D. [2]
Overview
Bleb-related endophthalmitis (BRE) is the second most frequent cause of postoperative endophthalmitis after acute and chronic post-cataract surgery endophthalmitis.
Historical Perspective
Classification
Pathophysiology
Causes
Epidemiology and Demographics
The incidence of bleb-related endophthalmitis is approximately range from 200 to 1300 per 100,000 individuals with . It's incidence is reported to be between 0.2% to 1.3%,2,3 and is more common with the use of antiproliferative agent (up to 3%) and even higher when the bleb is placed inferiorly (up to 9.4%).
Risk Factors
- Bleb leakage (increase the risk of bleb infection 26 fold)
- Inappropriate use of of anti-metabolites (such as 5-fluorouracil (5-FU))
- Inappropriate use of Mitomycn-C (MMC)
- Reduce mucin production
- General conjunctival thinning
- Reduced cellularity
- Avascular bleb
- Conjunctivitis,
- Upper respiratory infection,
- Blepharitis
- Diabetes
- Trabeculectomy alone compared to combined procedure
- Chronic antibiotic use
Screening
Natural History, Complications, and Prognosis
Natural History
Complications
Prognosis
A single-center retrospective review from the 1990s showed that the 5 year risk of blebitis and that of BAE is 6.3% and 7.5%, respectively.
Diagnosis
Diagnostic Criteria
History and Symptoms
Physical Examination
Laboratory Findings
Imaging Findings
X Ray
CT
MRI
Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Prevention
Primary Prevention
- Assessment of bleb leakage following tabeculectomy surgery
- Bleb revision with conjunctival advancement to manage avascular leaking blebs (100% success rate)
- Amiotic membrane grafting as a possible alternative to conjunctival advancement (45% success rate)
Secondary prevention
- Bleb revision with conjunctival advancement to manage avascular leaking blebs (100% success rate)
- Amiotic membrane grafting as a possible alternative to conjunctival advancement (45% success rate)