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Endophthalmitis Following XEN Stent Exposure
Bhavani Karri1, Chandni Gupta, Divya Mathews
1Stanley Eye Unit, Abergele hospital, Abergele, Conwy, Wales.
Journal of Glaucoma
|June 29, 2018
Summary
A case of XEN implant exposure led to sight-threatening endophthalmitis, highlighting potential risks with this glaucoma device. Proper hygiene is crucial to prevent such serious complications.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Medical Device Complications
Background:
- XEN45 Gel stents are a novel microsurgical device for glaucoma management.
- The flexible nature of XEN stents is intended to minimize risks of exposure.
- Increasing clinical experience with these devices is ongoing.
Observation:
- A patient developed endophthalmitis four months after uncomplicated XEN stent implantation.
- The patient presented with diarrhea preceding the onset of endophthalmitis.
- Exposure of the XEN stent at the subconjunctival entry site was observed.
Findings:
- The exposed XEN stent was associated with sight-threatening endophthalmitis.
- Treatment involved stent removal, pars plana vitrectomy, and intravitreal antibiotics.
- Managing intraocular pressure was challenging due to preservative allergy.
Implications:
- XEN stent exposure, potentially linked to hygiene, may be an underreported complication.
- This case underscores the importance of sterile techniques and hand hygiene in glaucoma surgery.
- Further vigilance and understanding of XEN stent complications are warranted.
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