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Risk Factors for Infection of Glaucoma Filtering Bleb

Purpose: To identify risk factors for an infection involving a glaucoma filtering bleb as reported by Soltau et al.

Description

Soltau et al identified risk factors for infection of a glaucoma filtering bleb. These can help identify a person who may benefit from closer monitoring and early aggressive therapy. The authors are from the University of Miami, the New York Eye and Ear Infirmary, and New York Medical College.


 

Infections identified:

(1) blebitis (mucopurulent infiltrate within the bleb with mild to moderate inflammation of the anterior segment)

(2) endophthalmitis

 

Most significant risk factor: presence of late onset bleb leak

 

Criteria for a bleb leak:

(1) spontaneous focal point source of aqueous leakage

(2) point source located in an area of interrupted conjunctiva

(3) occurs > 1 month post-operatively

(4) positive Seidel test

 

Risk factors with intermediate significance identified on multivariate analysis:

(1) black race

(2) filtering bleb on the inferior or nasal aspect of the globe

 

Other risk factors (Table 4, page 341):

(1) younger age (risk decreases from each 10-year increment in age; considering that the mean age was 60-66, risk is probably significant if age <= 50)

(2) type of glaucoma (primary open angle glaucoma > pseduoexfoliation, chronic angle-closure glaucoma > primary open angle glaucoma, "other" > primary open angle glaucoma)

 


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Specialty

Objective

ICD-10