Bleb infections: clinically different courses of "blebitis" and endophthalmitis

Ophthalmic Surg Lasers. 1997 Jun;28(6):452-60.


Background and objectives: To assess the differences in history, clinical course, and response between five cases of blebitis and three cases of endophthalmitis following mitomycin trabeculectomy.

Patients and methods: The authors conducted a retrospective review of eight consecutive cases of bleb-related infection following successful mitomycin trabeculectomy.

Results: All patients with blebitis responded to treatment with return of visual acuity and intraocular pressure to preinfection levels. In the three cases of endophthalmitis, one patient underwent enucleation, one had a final visual acuity of counting fingers, and the third had a visual acuity of 20/60.

Conclusions: Blebitis, a limited form of bleb-related infection with thin, cystic, leaky blebs, responds to intensive topical antibiotic treatment, returning visual acuity and IOP to preinfection levels. Bleb-related endophthalmitis causes a more virulent form of bleb-related infection that involves thin- or thick-walled blebs, with or without leakage, and poor visual prognosis despite immediate intensive topical, systemic, and intravitreal antibiotic administration combined with core vitrectomy.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Administration, Topical
  • Adult
  • Aged
  • Anti-Bacterial Agents
  • Antibiotics, Antineoplastic / administration & dosage
  • Bacteria / isolation & purification
  • Chemotherapy, Adjuvant / adverse effects
  • Conjunctiva / microbiology
  • Drug Therapy, Combination / therapeutic use
  • Endophthalmitis / microbiology*
  • Endophthalmitis / pathology
  • Endophthalmitis / therapy
  • Eye Infections, Bacterial* / etiology
  • Eye Infections, Bacterial* / pathology
  • Eye Infections, Bacterial* / therapy
  • Female
  • Follow-Up Studies
  • Glaucoma / surgery
  • Humans
  • Male
  • Middle Aged
  • Mitomycins / administration & dosage
  • Ophthalmic Solutions
  • Postoperative Complications / etiology
  • Postoperative Complications / pathology
  • Postoperative Complications / therapy
  • Reoperation
  • Retrospective Studies
  • Trabeculectomy / adverse effects*
  • Vitrectomy
  • Vitreous Body / microbiology
  • Vitreous Body / surgery


  • Anti-Bacterial Agents
  • Antibiotics, Antineoplastic
  • Mitomycins
  • Ophthalmic Solutions