RESUMEN
AIM: To investigate the rate, risk factors, clinical course, and treatment outcomes of endophthalmitis following glaucoma drainage implant (GDI) surgery. METHODS: A computerised relational database search was conducted to identify all patients who were implanted with Ahmed glaucoma valve (AGV) and developed endophthalmitis following surgery at the King Khaled Eye Specialist Hospital in Riyadh, Saudi Arabia, between 1 January 1994 and 30 November 2003. Only medical records of the patients who developed endophthalmitis were retrospectively reviewed. RESULTS: 542 eyes of 505 patients who were on active follow up were included in the study. Endophthalmitis developed in nine (1.7%) eyes; the rate was five times higher in children than in adults. Delayed endophthalmitis (developed 6 weeks after surgery) occurred in eight of nine eyes. Conjunctival erosion overlying the AGV tube was present in six of nine eyes. Common organisms isolated in the vitreous included Haemophilus influenzae and Streptococcus species. Multiple regression analysis revealed that younger age and conjunctival erosion over the tube were significant risk factors associated with endophthalmitis. CONCLUSION: Endophthalmitis is a rare complication of GDI surgery that appears to be more common in children. Conjunctival dehiscence over the GDI tube seems to represent a major risk factor for endophthalmitis. Prompt surgical revision of an exposed GDI tube is highly recommended.
Asunto(s)
Endoftalmitis/etiología , Implantes de Drenaje de Glaucoma/efectos adversos , Infecciones Relacionadas con Prótesis/microbiología , Adulto , Factores de Edad , Anciano , Niño , Preescolar , Endoftalmitis/microbiología , Infecciones Bacterianas del Ojo/etiología , Femenino , Cirugía Filtrante , Humanos , Lactante , Masculino , Persona de Mediana Edad , Periodo Posoperatorio , Estudios Retrospectivos , Factores de Riesgo , Dehiscencia de la Herida Operatoria/complicaciones , Resultado del Tratamiento , Agudeza VisualAsunto(s)
Lesiones de la Cornea , Lesiones Oculares Penetrantes/etiología , Migración de Cuerpo Extraño/etiología , Implantes de Drenaje de Glaucoma/efectos adversos , Glaucoma/cirugía , Preescolar , Lesiones Oculares Penetrantes/fisiopatología , Femenino , Migración de Cuerpo Extraño/fisiopatología , Glaucoma/congénito , Humanos , Implantación de Prótesis , Cicatrización de HeridasRESUMEN
Patients with phacomorphic glaucoma present with mature cataract, shallowing of the anterior chamber, and angle-closure glaucoma. The opaque ocular media due to cataract formation usually precludes visualization of the posterior segment of the affected eyes. The authors describe a 65-year-old man who presented with reduced vision and clinical findings typical of phacomorphic glaucoma. Preoperative ultrasonography revealed an intraocular tumor, and magnetic resonance imaging showed a high signal intensity in T1-weighted images and a low signal intensity in T2-weighted images consistent with choroidal melanoma. Histopathologic examination of the tumor after enucleation confirmed the diagnosis. The clinical findings characteristic of phacomorphic glaucoma may be associated with choroidal melanoma. Ultrasonography or other imaging studies should be performed on eyes with phacomorphic glaucoma and opaque ocular media to allow timely detection of any mass lesion and to guide appropriate surgical management.