Blebitis After EX-PRESS Glaucoma Filtration Device Implantation-A Case Series

To present the management and outcomes of blebitis in patients who underwent EX-PRESS Glaucoma Filtration Device (GFD) implantation.

Retrospective case series.

The study included 5 patients who developed blebitis following EX-PRESS GFD implantation.

Charts of all patients who underwent EX-PRESS GFD implantation at the Glaucoma Center of San Francisco between 2007 and 2013 were reviewed. Five patients with blebitis were identified and their clinical course was recorded.

Clinical course of blebitis.

Of 325 eyes that underwent EX-PRESS GFD implantation, 5 eyes (1.5%) with blebitis were identified. The mean interval between EX-PRESS GFD surgery and blebitis was 2.3±0.8 years. Four of the 5 eyes with blebitis had potential risk factors for bleb-related infection; 1 had chronic blepharitis, 2 had contact lens use, and one had 2 episodes of bleb leak before blebitis. All patients were treated with topical antibiotics; in addition, 3 received oral antibiotics and 1 received intravitreal antibiotics. None of the patients developed endophthalmitis. One patient had recurrent blebitis, which was treated with topical, oral, and intravitreal antibiotics. None of the patients had the device removed. The mean follow-up time after blebitis was 16.8±8.9 months (range, 10 to 32 mo).

This case series suggests that blebitis after EX-PRESS GFD implanted under a scleral flap may be treated without removal of the device. Further study is required to determine the optimal method of treating this condition.