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Postoperative infection in penetrating versus non-penetrating glaucoma surgery
  1. Ghee Soon Ang1,
  2. Zsolt Varga2,
  3. Tarek Shaarawy2,*
  1. 1 NHS Grampian, Aberdeen Royal Infirmary, United Kingdom;
  2. 2 Department of Ophthalmology, University Hospital of Geneva, Switzerland
  1. Correspondence to: tarek shaarawy, Genev, wtrwtw, geneve, 1211, Switzerland; tarek.shaarawy{at}hcuge.ch

Abstract

Aim: To review the literature for the incidence and risk factors for postoperative infection following both penetrating and non-penetrating glaucoma surgery.

Methods: A Pubmed review of the literature was performed for trabeculectomy, glaucoma drainage device procedures (Ahmed, Baerveldt and Molteno implants) and non-penetrating glaucoma surgery (deep sclerectomy and viscocanalostomy) for reports of postoperative infection, including blebitis, endophthalmitis, keratitis and orbital cellulitis. In addition, case series of non-penetrating glaucoma surgery with follow-up of at least 2 years were also reviewed.

Results: Sixty four articles on infections after glaucoma surgery were identified. Forty eight publications were related to infections following trabeculectomy, fifteen for glaucoma drainage devices, and only three for non-penetrating glaucoma surgery. There have not been any publications describing postoperative infective endophthalmitis associated with non-penetrating glaucoma surgery.

Conclusions: The literature on infections related to non-penetrating glaucoma surgery is sparse, in contrast to that for trabeculectomy and glaucoma drainage device procedures. Thus far, no case of endophthalmitis has been reported following non-penetrating glaucoma surgery, even with the use of intraoperative antimetabolites. However, there is currently insufficient evidence to conclusively demonstrate that NPGS is associated with significantly less risk of endophthalmitis and infection when compared to trabeculectomy and glaucoma drainage device implantation.

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