Latent Infections as a Risk Factor for Posttrabeculectomy Bleb Failure.
J Glaucoma
; 25(3): 306-11, 2016 Mar.
Article
en En
| MEDLINE
| ID: mdl-25651208
ABSTRACT
PURPOSE:
To investigate latent conjunctival Chlamydia trachomatis (CT) and Bacteroides fragilis (BF) infections as potential risk factors for posttrabeculectomy bleb failure. PATIENTS ANDMETHODS:
This retrospective observational study included 50 primary open-angle glaucoma eyes of 50 patients who were submitted to trabeculectomy without cytostatics from September 2010 to June 2011 and were followed up for at least a year. Preoperatively, conjunctival scrapings were taken and their specimens subjected to polymerase chain reaction, direct fluorescent assay and cell culture testing for CT, and culture for BF on blood agar medium. Serum CT-specific IgG and IgA and tear interleukin (IL)-1ß and IL-8 concentrations were measured with enzyme-linked immunosorbent assay. We defined bleb failure as intraocular pressure >21 mm Hg with antiglaucoma medications, resulting from reduced bleb filtration capacity due to bleb fibrosis, fistula obstruction, flattened bleb, or encapsulated bleb, and no earlier than 2 weeks after surgery. At the time of the reintervention, a scleroconjunctival biopsy was obtained for histopathology (including direct fluorescent assay testing for CT). Eyes were divided into a failure group and a nonfailure group, depending on whether they developed bleb failure (required reintervention) or not within a follow-up year.RESULTS:
In the failure group (n=18), the frequencies of detection of CT and BF in conjunctival specimens were 27.8% and 66.7%, respectively, versus 0% and 9.4% in the nonfailure group (n=32). CT and BF were detected in 11.1% and 11.1%, respectively, of scleroconjunctival biopsies. IgG and IgA seropositivity to CT was found in 66.7% and 33.3%, respectively, of the failure group patients, versus 9.4% and 0% of the nonfailure group patients. Tear IL-1ß and IL-8 levels were markedly elevated in the failure group (468.83±80.43 and 107.89±15.11 pg/mL, respectively) versus the nonfailure group (22.34±5.43 and 9.34±2.83 pg/mL, respectively).CONCLUSION:
Being a contributor to low-grade conjunctival inflammation, latent conjunctival CT, and BF infections in primary open-angle glaucoma patients represent risk factors for posttrabeculectomy bleb failure.
Texto completo:
1
Colección:
01-internacional
Asunto principal:
Complicaciones Posoperatorias
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Bacteroides fragilis
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Trabeculectomía
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Infecciones Bacterianas del Ojo
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Chlamydia trachomatis
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Conjuntivitis Bacteriana
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Glaucoma de Ángulo Abierto
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
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Observational_studies
/
Risk_factors_studies
Idioma:
En
Revista:
J Glaucoma
Asunto de la revista:
OFTALMOLOGIA
Año:
2016
Tipo del documento:
Article
País de afiliación:
Rusia