Endophthalmitis and blebitis following deep sclerectomy and trabeculectomy with routine use of mitomycin C.


Journal

Acta ophthalmologica
ISSN: 1755-3768
Titre abrégé: Acta Ophthalmol
Pays: England
ID NLM: 101468102

Informations de publication

Date de publication:
May 2023
Historique:
revised: 20 09 2022
received: 22 05 2022
accepted: 29 10 2022
medline: 11 4 2023
pubmed: 11 11 2022
entrez: 10 11 2022
Statut: ppublish

Résumé

The purpose of the study was to investigate the incidence for endophthalmitis and blebitis after deep sclerectomy (DS) and trabeculectomy with routine use of Mitomycin C (MMC) 0.4 mg/ml. Electronic medical records of patients who underwent surgery 1/2008-4/2020 were reviewed. Cumulative incidence for bleb-associated infection (BAI), including both endophthalmitis and blebitis, was calculated with cumulative incidence function (CIF) and Kaplan-Meier analysis. Risk factors for BAI were evaluated with univariate competing risk regression analysis and Log-rank analysis. Competing event in CIF was death. In this retrospective single-centre cohort study, a total of 2653 patients and 3411 eyes underwent surgery: 3478 glaucoma surgeries, 2419 DS and 1059 trabeculectomies. Two cases of endophthalmitis and three of isolated blebitis developed. Median follow-up from the most recent surgery on the eye until the end of the study was 5.5 years, and until last visit at the ophthalmology department was 1.9 years. For the whole follow-up period in CIF-analysis, cumulative incidence for BAI was 0.16% (95% CI 0.06-0.36) at five years. Incidence was higher with eyes not treated with an antifibrotic during surgery (sub-hazard ratio 11.66, 95% CI 1.94-70.21, p = 0.007). Cumulative incidence between surgery and last visit with Kaplan-Meier analysis was 0.21% (95% CI 0.08-0.52) at five years, similarly, not using an antifibrotic increased incidence (Log-rank p < 0.001). Cumulative incidence for BAI was low despite routine use of high-dose MMC.

Identifiants

pubmed: 36352754
doi: 10.1111/aos.15287
doi:

Substances chimiques

Mitomycin 50SG953SK6

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

285-292

Subventions

Organisme : Glaukooma Tukisäätiö Lux
Organisme : HUS Helsinki University Hospital
Organisme : Evald and Hilda Nissi Foundation

Informations de copyright

© 2022 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

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Auteurs

Tuulia Kankainen (T)

Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

Mika Harju (M)

Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

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