BLEB RELATED OCULAR INFECTION IN CHILDREN AFTER TRABECULECTOMY WITH MITOMYCIN-C

Objective: The purpose of the study is to report the clinical course o f bleb-related ocular infection in children after trabeculectomy with adjunctive mitomycin C. Design: The study design was a retrospective r eview of all patients with a diagnosis of bleb-related ocular infectio n after trabeculectomy with adjunctive mitomycin C. Participants: Thre e children were identified in whom late postoperative bleb-related ocu lar infection developed. Intervention: Treatment consisted of vitreous biopsy with intravitreous antibiotic and corticosteroid injection and /or bleb culture with topical and intravenous antibiotic administratio n. Main Outcome Measures: Visual acuity and intraocular pressure were measured. Results: Bleb-related ocular infection developed an average of 16.7 +/- 10.9 months after trabeculectomy (range, 4-23 months). The mean age at presentation was 7.0 +/- 2.6 years (range, 4-10 years). V itreous cultures were positive for staphylococci in two cases. A bleb culture from the third case also grew staphylococcus. All of the child ren recovered their initial vision after treatment of infection. Howev er, one lost six lines of vision after a subsequent retinal detachment . Additional glaucoma surgery was required in one patient. Conclusions : Late bleb-related ocular infection may occur in children after trabe culectomy with mitomycin C and is characterized by abrupt onset, bleb infiltration, and rapid progression. Despite early preservation of vis ion after treatment of infection, significant late visual loss can occ ur.