To determine the rate, clinical features, and outcomes of filtering-associated endophthalmitis in eyes that underwent trabeculectomy or tube-shunt implantation.
Retrospective database study with selective chart review.
Eyes that underwent incisional glaucoma surgery at our institution between January 1, 2012, and December 31, 2019.
An electronic medical record database was used to identify all eyes that underwent trabeculectomy or tube-shunt implant during the study period. Date of surgery, date of last ophthalmology clinic visit, and filtering-associated endophthalmitis diagnoses were obtained and used to perform a Kaplan-Meier analysis. Log-rank test was used to compare rates of filtering-associated endophthalmitis following trabeculectomy and tube-shunt implant. Microbiology, management and clinical outcomes data from patients with filtering-associated endophthalmitis were also collected and analyzed.
Cumulative risk of filtering-associated endophthalmitis as determined by Kaplan-Meier analysis. Visual acuity improvement to within 2 lines of baseline at 3 months follow up and globe salvage at last available follow up in eyes with filtering-associated endophthalmitis.
Kaplan-Meier analysis of 1,582 eyes that underwent incisional glaucoma surgery yielded a 5-year cumulative incidence for filtering-associated endophthalmitis of 1.32%. There was no statistically significant difference between rate of endophthalmitis following trabeculectomy or tube-shunt implant (log-rank test, p=0.761). Seven of 16 (43.8%) cases of filtering-associated endophthalmitis were culture positive from either vitreous sample or explanted tube-shunt. Recovery of vision to within 2 lines of pre-endophthalmitis baseline was achieved in 53% of cases at 3 months follow up. Rate of globe salvage was 100% at last available follow up.
Risk of filtering-associated endophthalmitis is persistent and relatively constant for at least 5 years following incisional glaucoma surgery. The overall prognosis of filtering-associated endophthalmitis remains poor, however good visual and anatomic outcomes can be achieved in some patients with prompt intervention.
Copyright © 2020. Published by Elsevier Inc.