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PURPOSE: To report a case of endophthalmitis occurring shortly after EX-PRESS implantation with the formation of a corneal infiltrate overlying the EX-PRESS, requiring device removal for adequate treatment. PATIENT AND METHODS: This is a case report of a 56-year-old male with uncontrolled open-angle glaucoma who underwent right eye EX-PRESS implantation under a partial-thickness scleral flap with intraoperative application of mitomycin C. RESULTS: On postoperative day 16, the patient was found to have bleb-associated endophthalmitis with a corneal infiltrate adjacent to the bleb and overlying the EX-PRESS. Two days after pars plana vitrectomy with injection of intravitreal antibiotics, the corneal infiltrate was enlarging and centered on the distal end of the EX-PRESS, while the back plate of the device became partially exposed. Clinical improvement was not achieved until the device was removed and the original surgical site was reinforced with a patch graft. By week 10 after device removal, intraocular pressure was 8 mm Hg and the corneal infiltrate had resolved into an opaque, partially vascularized scar. CONCLUSIONS: Endophthalmitis after EX-PRESS implantation may be complicated by corneal infiltrate formation and persistent infection. Clinicians should monitor for these complications in the management of infection after EX-PRESS implantation and consider early device removal to achieve resolution.
Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO.
Full article12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
12.8.11 Complications, endophthalmitis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)