Analysis of clinical and pathogenic bacteria of bleb associated endophthalmitis after glaucoma surgery

Abstract

Objective To observe the clinical features, pathogenic bacteria distribution and drug sensitivity of bleb-related endophthalmitis after trabeculectomy. Methods The data of 28 eyes of 28 cases with bleb-associated endophthalmitis after trabeculectomy from Jan.2011 to Jun.2017 were analyzed retrospectively.The age of onset, duration of endophthalmitis to operation and visual acuity were recorded. The samples of aqueous humor and vitreous were sent to microbiological culture and drug sensitivity test. Results The average occurrence time of endophthalmitis was 16 d-16 years, average (54.2±39.1) months after the last operation. The samples were positive to the bacteria culture in 11 eyes. The positive rate of bacteria was 42.3%. Streptococcus and Staphylococcus were the main pathogenic bacteria. Streptococcus and Staphylococcus were sensitive to Vancomycin. Inflammation was controlled after intravitreal injection of antibiobics or vitrectomy in 25 eyes(89.3%). The visual acuity ≥0.05 was in 10 eyes(35.7%). There were 8 eyes (28.6%) with no light perception. Three cases(10.7%) eventually underwent enucleation of eyeball. Conclusion Most of the endophthalmitis associated with filtering bleb is delayed endophthalmitis. Streptococcus and Staphylococcus are the most common pathogens. Although the infection is successfully treated, but the visual acuity is poor. Key words: Endophthalmitis, infectious; Glaucoma; Pathogen