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WGA Rescources

Abstract #61361 Published in IGR 17-1

Endophthalmitis With Corneal Infiltrate After EX-PRESS Glaucoma Drainage Device Implantation

Cherof AM; Soohoo JR; Kahook MY; Seibold LK
Journal of Glaucoma 2016; 25: e277-e279


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 article

Classification:

12.8.2 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)



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