J Korean Ophthalmol Soc.  1999 Jul;40(7):2036-2042.

A Case of Late Onset Bleb-Related Endophthalmitis after Trabeculectomy with Mitomycin C

• Kil YG
• Jin SM
• Chung DY

Abstract

Adjunctive use of Mitomycin C (MMC)in trabeculectomy has greatly improved the success rate. Trabeculectomy with MMC, however, has resulted in a cystic and thin-walled filtering bleb, which may be more susceptible to infection. Late onset bleb-related endophthalmitis developed in a glaucoma patient at 40 months after MMC trabeculectomy. Filtering bleb in this patient had been avascular, thin-walled and cystic prior to the occurrence of endophthalmitis. Patient complained of decreased visual acuity with ocular discomfort and conjunctival injection and showed a mucopurulent infiltrate within the bleb, hypopyon and vitritis. Visual acuity was hand motion. An intensive treatment included anterior chamber irrigation, lensectomy,par plana vitrectomy, intravitreal and subconjunctival antibiotics (vancomycin,gentamycin) injection and topical and systemic corticosteroid (dexamethasone) and antibiotics,which led to a resolution.

Keyword

Endophthalmitis; MMC; Thin-walled blebs; Trabeculectomy

MeSH Terms

Anterior Chamber
Anti-Bacterial Agents
Blister
Endophthalmitis*
Glaucoma
Hand
Humans
Mitomycin*
Trabeculectomy*
Visual Acuity
Vitrectomy
Anti-Bacterial Agents
Mitomycin