Bleb-related endophthalmitis (BRE) is a potentially blinding consequence of glaucoma filtration surgery. Pars plana vitrectomy (PPV) and vitreous biopsy, and intravitreal antibiotic (TI) injection produced comparable visual and intraocular pressure (IOP) outcomes, according to the current investigation. This research compared the effects of PPV and TI on visual acuity (VA) and IOP in patients with delayed-onset BRE. At the Bascom Palmer Eye Institute (Miami, FL) and the University of Florida (Gainesville, FL), a retrospective chart review was performed to identify patients treated for BRE with at least 1 month of follow-up from the inception of an electronic health record (2014 and 2011, respectively) through 2021. At the time of their endophthalmitis diagnosis, all patients had recently recovered from surgery to remove blebs caused by glaucoma. About 39 eyes from 39 patients were included in the analysis (33 from Bascom Palmer and 6 from the University of Florida). For 34 out of 39 eyes (87.2%), trabeculectomy was the chosen treatment. The most commonly isolated organisms were Streptococcus (9 eyes; 23.1%) and Staphylococcus (8 eyes; 20.5%), and these numbers were virtually identical in the 2 treatment groups (P=0.49). Regarding the minimum angle of resolution logarithm, the PPV group had worse VA at baseline (2.51 vs. 2.16, P=0.04), but both groups had identical VA at the last follow-up (P=0.48). Average IOP was 15.1 mm Hg in the PPV group after recovery from BRE, while it was 12.6 mm Hg in the TI group on 1.2 medicines to lower IOP (IOP: P=0.56; meds: P=0.80). Around 44% of PPV and 16% of TI eyes underwent further glaucoma surgery (P=0.09). After initial PPV in eyes with delayed-onset BRE, isolated organisms, visible results, and IOP management were comparable to TI.

Source: journals.lww.com/glaucomajournal/Fulltext/2022/09000/Comparison_of_Outcomes_From_Delayed_Onset.7.aspx