Clinical features of bleb-related infection: a 5-year survey in Japan

Purpose: To present clinical features and microbial data for bleb-related infections obtained by the 5-year-long Japan Glaucoma Society Survey of Bleb-related Infection (JGSSBI). Methods: This multicentre prospective observational study was conducted in 82 clinical centres in Japan. A total of 170 bleb-related infections developed in 157 eyes of 156 patients during a 5-year period. The ophthalmological and microbial data were analysed. Results: The patient age at first infection was 59.3 ± 17.7 years [mean ± standard deviation (SD)], and the period between the last glaucoma surgery and the first infection was 6.9 ± 5.8 years (mean ± SD; range: 0.3–41 years). Bleb leakage was noted significantly more frequently in eyes with repeated infections. The stage of infection at diagnosis was stage I in 91 infections (54%), stage II in 30 infections (18%), stage IIIa in 18 infections (11%), and stage IIIb in 31 infections (18%). Staphylococcus species were the most frequently isolated microbe (41%), followed by Streptococcus species (32%). Streptococcus species, coagulase-negative Staphylococcus, Haemophilus influenzae, and Enterococcus species were the major bacteria isolated in the late-stage infections. Conclusions: The JGSSBI project has revealed several characteristics of bleb-related infection in Japan, which include the significance of bleb leakage in the development of repeated infections and the distribution of bacterial isolates.