Outpatient treatment of bleb infection

Objective: To determine the outcome of outpatient treatment of bleb infection Design: Retrospective review. Setting: University referral center. Patients: Twelve eyes with bleb infection and without clinical vitreous involvement of 11 patients treated as outpatients from January 1994 to May 1996. Interventions: After culture of the bleb surface, treatment consisted of intensive topical antibiotics alone (9 eyes), combined with subconjunctival antibiotic injection (1 eye), oral antibiotics (1 eye), or both (1 eye). Five eyes received topical corticosteroids. Main Outcome Measures: Visual acuity, intraocular pressure, and bleb characteristics. Results: All eyes responded to treatment within 24 to 48 hours, and recovered visual acuity to within 1 line of the preinfection level. Intraocular pressure continued to be controlled after resolution of infection in 11 eyes (92%); 1 bleb failed and medical therapy was resumed. Bleb leaks were noted during treatment of infection in 11 eyes, and 5 eyes (42%) underwent bleb revision. Organisms cultured from the bleb surface included Staphylococcus aureus (8 eyes), Haemophilus influenzae (2 eyes), and Streptococcus (1 eye). Outpatient treatment costs were estimated to be 78% less than inpatient treatment costs, per 24 hours. Conclusion: Outpatient treatment of bleb infection was efficacious in this group of patients.