advertisement
Abstract #86665 Published in IGR 21-2
Prompt vitrectomy for management of endophthalmitis in setting of unexposed glaucoma drainage implant
Junttila TL; Lema GM; Sieminski SFAmerican journal of ophthalmology case reports 2020; 18: 100671
PURPOSE: To highlight a rare case of fulminant endophthalmitis in the late post-operative stage after glaucoma drainage device implantation without evidence of device exposure, and to share the unique management that resulted in successful restoration of vision and intraocular pressure control. OBSERVATIONS: Endophthalmitis after glaucoma drainage implantation (GDI) is a rare complication most often associated with exposure of the device. Management options are limited, but removal of GDI is a common approach in the setting of an exposed implant. Visual acuity outcomes are often significantly reduced despite adequate treatment. There is little in the existing literature about management of late-onset endophthalmitis in the setting of a GDI without implant exposure. Here we present such a case that was successfully managed by prompt pars plana vitrectomy and removal of tube from the anterior chamber with subsequent re-insertion and patch graft. Our case results in a restoration of baseline visual acuity and IOP control at 7 months follow up. CONCLUSIONS AND IMPORTANCE: Endophthalmitis occurring after GDI implantation is a challenging complication to manage. Many physicians resort to removal of device for treatment, and a majority would treat initially with intravitreal antibiotic injection of antibiotics rather than prompt pars plana vitrectomy. This article provides a different approach that avoids removal of the device.
Ross Eye Institute, University at Buffalo, 1176 Main Street, Buffalo, NY, USA.
Full articleClassification:
12.8.11 Complications, endophthalmitis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
12.16 Vitrectomy (Part of: 12 Surgical treatment)
12.8.2 With tube implant or other drainage devices (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
