Outpatient treatment of bleb infection
P. P. Chen, S. J. Gedde, D. L. Budenz and R. K. Parrish 2nd
pchen@u.washington.edu
OBJECTIVE: To determine the outcome of outpatient treatment of bleb
infection after trabeculectomy. DESIGN: Retrospective review. SETTING:
University referral center. PATIENTS: Twelve eyes with bleb infection and
without clinical vitreous involvement of 11 patients treated as
out-patients from January 1994 to May 1996. INTERVENTIONS: After culture of
the bleb surface, treatment consisted of intensive topical antibiotics
alone (9 eyes), combined with subconjunctival antibiotic injection (1 eye),
oral antibiotics (1 eye), or both (1 eye). Five eyes received topical
corticosteroids. MAIN OUTCOME MEASURES: Visual acuity, intraocular
pressure, and bleb characteristics. RESULTS: All eyes responded to
treatment within 24 to 48 hours, and recovered visual acuity to within 1
line of the preinfection level. Intraocular pressure continued to be
controlled after resolution of infection in 11 eyes (92%); 1 bleb failed
and medical therapy was resumed. Bleb leaks were noted during treatment of
infection in 11 eyes, and 5 eyes (42%) underwent bleb revision. Organisms
cultured from the bleb surface included Staphylococcus aureus (8 eyes),
Haemophilus influenzae (2 eyes), and Streptococcus (1 eye). Outpatient
treatment costs were estimated to be 78% less than inpatient treatment
costs, per 24 hours. CONCLUSION: Outpatient treatment of bleb infection was
efficacious in this group of patients.
