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

Kil, Young Gab; Jin, Suck Man; Chung, Dug Young

Case Report

Journal of the Korean Ophthalmological Society 1999;40(7):2036-2042.
Published online July 1, 1999.

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

Young Gab Kil, Suck Man Jin, Dug Young Chung

Department of Ophthalmology, Presbyterian Medical Center, Chonju, Korea.

Mitomycin C를 이용한 섬유주절제술 후 발생한 여과포관련 만발성안내염 1예

길영갑(Young Gab Kil),진석만(Suck Man Jin),정덕영(Dug Young Chung)

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.

Key Words: Endophthalmitis;MMC;Thin-walled blebs;Trabeculectomy