A Case of Bleb Related Endophthalmitis Complicated with Retinal Detachment
Glaucoma-filtering procedures (e.g., trabeculectomy) is a standard surgical procedure commonly done when maximally tolerated medical therapy or laser trabeculoplasty fails to adequately control intraocular pressure (IOP). The filtering procedure creates a fistula between the anterior chamber and the subconjunctival space, covered with thin sclera and conjunctiva that allows excess aqueous humour to be absorbed into the systemic circulation. Thus, the presence of a filtering bleb poses an enduring risk of a bleb related infection (BRI) over the patient’s lifetime (1). To improve the success of these procedures, it has now become routine to use intraoperative antifibrotic agents (e.g., mitomycin and fluorouracil) as an adjunct to standard trabeculectomy (2). Although these agents have improved the chances of long-term IOP control they have further predisposed to an increased incidence of postoperative complications including late-onset filtering bleb-related infections (1).