Late-Onset Endophthalmitis Associated with Glaucoma Surgery.
10.3341/jkos.2014.55.11.1651
- Author:
Sun Young KIM
1
;
Young Jung RHO
;
Su Young KIM
Author Information
1. Department of Ophthalmology and Visual Science, Uijeongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine, Uijeongbu, Korea. cassiopeia-su@hanmail.net
- Publication Type:Original Article
- Keywords:
Endophthalmitis;
Glaucoma;
Glaucoma surgery
- MeSH:
Candida;
Endophthalmitis*;
Follow-Up Studies;
Glaucoma*;
Hand;
Humans;
Medical Records;
Prognosis;
Propionibacterium acnes;
Retrospective Studies;
Streptococcus;
Trabeculectomy;
Vancomycin;
Visual Acuity;
Vitrectomy
- From:Journal of the Korean Ophthalmological Society
2014;55(11):1651-1658
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To report cases of late-onset endophthalmitis associated with glaucoma surgery. METHODS: We retrospectively reviewed the medical records of 4905 consecutive patients who underwent glaucoma surgery (trabeculectomy or valve implant surgery) from January 1, 1988 to March 31, 2013. RESULTS: There were a total of 14 late-onset endophthalmitis (0.29%) cases associated with glaucoma surgery occurring at 1 year to 21 years postoperatively. Six cases (6/993, 0.60%) occurred after valve implantation and the other 8 cases (8/3912, 0.20%) occurred after trabeculectomy (p = 0.046). All but one patient were injected with fortified vancomycin and ceftazidim. Four patients also received a vitrectomy with the injection. The implanted valve was removed in 2 cases. In four cases, organisms were found in the culture (staphylococcus.aureus, streptococcus viridians, propionibacterium acnes and candida parapsilosis). After 1 year, only 4 patients achieved a visual acuity above 4/200 compared with other patients who had a final visual acuity of hand motion or worse. Three patients (33%) who developed endophthalmitis underwent other intraocular procedures. CONCLUSIONS: Late-onset endophthalmitis associated with glaucoma surgery can often occur with fulminant sight-threatening complications. Due to devastating sequelae, the surgeon should carefully check the surgery site in the patients who underwent glaucoma surgery at every follow-up visit. Delayed endophthalmitis after glaucoma surgery still carries a poor visual prognosis and its onset is difficult to predict. Therefore, patients who undergo glaucoma surgery should be educated and carefully evaluated during regular follow-ups.
