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Risk Factors for Late-Onset Infection Following Glaucoma Filtration Surgery
Henry D. Jampel, MD, MHS;
Harry A. Quigley, MD;
Lisa A. Kerrigan-Baumrind, MS;
B. Michele Melia, ScM;
David Friedman, MD, MPH;
Yolanda Barron, MS;
for the Glaucoma Surgical Outcomes Study Group
Arch Ophthalmol. 2001;119:1001-1008.
Objective To determine the risk factors for late-onset infection following glaucoma
filtration surgery.
Methods We performed a case-control study comparing 131 cases of late-onset
infection collected from 27 surgeons at 10 centers with 500 controls matched
for date of surgery and surgeon. The criterion for the presence of infection
was severe anterior chamber reaction occurring later than 4 weeks after surgery.
An opaque bleb and positive culture results were not required for diagnosis.
Risk factors were identified by univariate and multivariate logistic regression
analyses.
Results Some of the risk factors that were statistically significant in the
multivariate model after adjusting for age, race, and sex were (1) performance
of a full-thickness rather than a guarded procedure (risk ratio [RR], 13.1;
95% confidence interval [CI], 2.12-80.9), (2) filtration surgery performed
without concurrent cataract surgery (RR, 2.25; 95% CI, 1.24-4.08), (3) use
of mitomycin (RR, 2.48; 95% CI, 1.06-5.83), (4) intermittent use of antibiotics
after surgery (RR, 2.10; 95% CI, 1.09-4.02), and (5) continuous use of antibiotics
after surgery (RR, 5.94; 95% CI, 2.09-16.9).
Conclusions Eyes undergoing full-thickness procedures or filtration surgery without
cataract extraction are at increased risk for late infection. Intraoperative
mitomycin and episodic or continuous antibiotic use after the postoperative
period are associated with an increased risk of infection.
From the Wilmer Eye Institute, Baltimore, Md.
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