Risk Factors for Glaucoma Filtering Bleb Infections

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Abstract
GLAUCOMA filtering surgery is commonly performed to control intraocular pressure (IOP) when medical therapy or laser trabeculoplasty fail to do so. Associated with this procedure, however, is a small, but significant, risk of late-onset bleb-related infection. Previously documented risk factors for bleb-related infection include use of antifibrotic agents in conjunction with filtering surgery1-3 and inferior location of the filtering bleb.4-7 Because the conjunctiva and sclera provide the main barriers against entry of infectious organisms into the eye, disruption of these barriers due to glaucoma filtering surgery, combined with a leak in the conjunctival filtering bleb, may be an additional risk factor. In fact, the tear film, which contains bacteria known to harbor organisms capable of causing endophthalmitis,8-10 has been shown to have direct access to the anterior chamber via a leaking filtering bleb.11

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